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Safety Gemba walk template

Safety Gemba walk template

Ensure a safer workplace with Lumiform’s free Safety Gemba Walk template. Identify hazards, evaluate safety measures, and implement actionable improvements. Download now to enhance safety awareness and maintain a secure working environment.

Use this template
or download pdf
Safety Gemba walk template

Ensure a safer workplace with Lumiform’s free Safety Gemba Walk template. Identify hazards, evaluate safety measures, and implement actionable improvements. Download now to enhance safety awareness and maintain a secure working environment.

Use this template
or download pdf

About the Safety Gemba walk template

A Safety Gemba Walk Template is a useful tool for workplace safety inspectors to check the safety of a workplace. The purpose of the Safety Gemba Walk Template is to identify potential hazards, assess current safety measures and make recommendations for improvement.

Picture a workplace where safety isn't just a priority—it's a guarantee. The Safety Gemba Walk template is your blueprint for identifying potential hazards, evaluating current safety measures, and crafting actionable improvements. This isn't just a template; it's a game-changer. With a structured approach, you ensure your workplace isn't just compliant but a fortress of safety. It is your way of making the future of the workplace safer, smarter, and more efficient.

Why use a Safety Gemba walk template for workplace safety

The objective of the safety Gemba walk template is to provide a systematic way to observe and document safety practices in the workplace. By using this template, your team can identify safety hazards, ensure compliance with safety regulations, and implement corrective actions.  The benefits include enhanced safety awareness, thorough documentation of safety issues, and actionable insights that drive continuous safety improvements. This template stands out by offering a comprehensive framework that ensures no safety detail is overlooked, making it easier to maintain a safe working environment.

Key elements of the safety Gemba walk template

The safety Gemba walk template includes several key elements designed to capture comprehensive data during your safety walks.
  • PPE & Safe Work Practices: This section checks the correct use and condition of personal protective equipment (PPE) and adherence to safe work practices.
  • Lifting Devices: Ensures that material lifting devices are in good condition and used correctly, preventing accidents and injuries.
  • Emergency Exits: Verifies that aisles and emergency exits are not blocked, ensuring quick and safe evacuation in case of an emergency.
  • Electrical Safety: Checks for proper labeling, condition of electrical equipment, and compliance with safety standards to prevent electrical hazards.
  • Mobile Equipment: Ensures that inspections are completed on mobile equipment and that operators are trained and licensed.
  • Material Storage: Verifies that materials are stored safely and organized to prevent accidents.
Upgrade your workplace safety today!  Download Lumiform’s Safety Gemba Walk template to proactively identify hazards, assess current safety measures, and implement improvements for a secure environment. This isn't just about compliance; it's about creating a culture of safety and efficiency. Take the first step towards a safer, smarter workplace now.

Related categories

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  • Templates for business processes
Preview of the template
Audit
PPE & Safe Work Practices
Correct PPE worn and is it in good condition?
Metatarsal safety shoes worn and are they in good condition
Hearing protection worn
Gloves (if required)
Other required PPE?
Lifting Devices
Material lifting devices used and are they in good condition
Can operator explain daily inspection performed on lifting devices
Inspect lifting devices for worn or damaged devices
Are suspended loads attended
Suspended loads must never be lifted over employees
Safety Shower / Eye Wash Station
Is their a shower of eye station located where acids / bases (corrosives) used. " Sodium Aluminate"
Are they inspected monthly and access not blocked
Are eye wash stations available in high dust areas
Emergency Exits
Aisles and emergency exits not blocked
Electrical
Is voltage indicated on electrical control enclosures, power cabinets,, junction boxes etc.
Arc Flash label present on electrical control enclosures, power cabinets, junction boxes etc.
Clearance in front of electrical enclosures 36" (0-150v) and 42" (151-600v)
Chords are free from frays and damage
Extension cords only allowed for temporary situations
GFCI's required on portable electric tools and in areas where wetness or damage to cord is possible
Are knockout plugs present on all electrical enclosures
Mobile Equipment
Are inspections being completed on equipment, prior to being used before each shift
Mobile equipment license and training current within 3 years
Seatbelt used whenever forklift operated
Material Storage Area
Material organized and rotated by date
Material not triple stacked, only two high
Flammable Cabinets
Only flammable liquids in cabinet (no paper, wood or plastic stored in cabinet)
Cabinets undamaged
No more than 3 cabinets within 100 square feet
Environmental
Are all areas free from spills?
Machine Guarding
Is point of operation (grinding wheel, etc.) protected such that inadvertent contact is prevented?
Flywheels, gears, shafts, pulleys, belts, gears, sprockets, chains and couplings guarded to protect employees
E-stop button present
Walking / Working surfaces
Are the walkways clear and free of debris
Are all holes or floor openings guarded?
Fire Extinguishers
Monthly Inspection completed / Verify completely charged
Confined space
Marked with proper signage (permit required sign or non permit required sign
HAZCOM
All containers labeled. (Original container with Manufacturers Label or secondary container with HMIS label)
Do employees know how to access an MSDS for a chemicals used?
Lockout / Tagout
Is machine specific energy control procedure present?
Are LOTO labels present
Compressed Air Nozzles
Are nozzles labeled as OSHA compliant. (regulate air pressure to 30psi or less)
Compressed Gas Cylinder Storage
Are cylinders identified with a durable label that clearly identifies the cylinder contents and gives a brief description of the potential hazard?
Cylinders secured with chain, lab strap or hard stock device located on the upper one third of the cylinder
Nesting methods for storage are prohibited. Acceptable means of storage include individual chains or straps, holding racks, cylinder carts etc.
Flammable gasses shall be stored at least 20 feet from oxidizers and any other source of ignition or separated by an approved firewall
OE and Standard Work
Material consumption be tracked PP/T?
Are 5S audits and Safety audits posted and current
Observe if standard work is being followed
Area clean & organized (less than 1 day of dirt)?
Aisles and emergency exits not blocked?
Do the employees know: (Interview a few people)
How to report suggestions
Who to report incident or injuries to and how long they have to do it in "as soon as it happens"
How to do and R3 and what it is
What is standard work and where is it located
What do they do if they find a problem
What a STOP card is and do they have them available
This template was downloaded 335 times

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This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.
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