close
lumiform
Lumiform Mobile audits & inspections
Get App Get App

Kitchen Safety Inspection Form

Rated 5/5 stars on Capterra

Say goodbye to paper checklists!

Lumiform enables you to conduct digital inspections via app easier than ever before
  • Cut inspection time by 50%
  • Uncover more issues and solve them 4x faster
  • Select from over 5,000 expert-proofed templates

Digitalize this paper form now

Register for free on lumiformapp.com and conduct inspections via our mobile app

  • Cut inspection time by 50%
  • Uncover more issues and solve them 4x faster
  • Select from over 4000 expert-proofed templates
Rated 5/5 stars on Capterra

Kitchen Safety Inspection Form

General Information

Building

Department

Inspector(s)

Date

Housekeeping

Does the area have a clean and orderly appearance?

Is the kitchen free from trip/slip hazards?

Are "wet floor signs" or equivalent available and used when mopping floors?

Personal Protective Equipment

Are heat-resistant gloves available and used where required?

Are cut-resistant gloves available and used where required?

Is clothing with short or close-fitting sleeves worn while cooking?

Fire Protection

Are exits clearly identified and accessible?

Are fire extinguishers available and clearly accessible?

Are all fire extinguishers mounted to the wall?

Have all fire extinguishers been serviced within the past 12 months?

Are emergency pull stations visible and clearly accessible?

Do sprinkler heads have at least 18 inches of vertical clearance?

Are hoods, ducts, and filters kept free of grease accumulation?

Are combustible materials located away from ranges and other hot surfaces?

Electrical Safety

Is all electrical equipment in good condition (no exposed wiring/frayed cords)?

Are all disconnecting means labeled to indicate their use or equipment served?

Is at least three feet of clear space provided in front of all electrical panels?

Are all electrical openings (knockouts) covered?

Are electrical enclosures (switches, outlets, etc) equipped w/ tight-fitting covers?

Are sufficient outlets provided to avoid the use of extension cords?

Are GFCI outlets provided where required?

Equipment/Machinery

Is equipment free from any exposed moving parts/pinch points?

Is the machine guarding in good condition and working properly?

Are all warning labels legible (e.g. hot surface labels)?

Are knives kept sharp and stored in racks or knife blocks when not in use?

Are step ladders in good condition?

Material Storage and Handling

Is all material stacked in a stable manner?

Are overhead objects secure?

Do employees use proper manual lifting techniques?

Occupational Health

Does ventilation have adequate flow?

Is lighting adequate?

Are there any repetitive motion concerns or awkward work postures?

Are Material Safety Data Sheets (MSDS's) available for all chemicals?

Hazardous Waste

Are waste materials placed in the proper receptacles?

Is waste removed on a routine basis?

Miscellaneous

Are there any other miscellaneous hazards not covered by checklist?

Conclusion

Note any comments related to specific hazards uncovered during the inspection:

Inspector's Signature

Share this template:

Similiar templates