Date
Inspector
Location
Item | Yes | No | NA | Notes / Action Required | Upload File | ||
|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | ||
1 | Aisles and passageways are kept clear and at least 36 inches (91 cm) wide. | ||||||
2 | Floors are dry and free of spills, grease, or debris. | ||||||
3 | Carpets are secured and free of tears or "tripping curls." | ||||||
4 | Floor holes or pits are protected by covers or physical railings. | ||||||
5 | Stairways have secure handrails and non-slip treads. |
Item | Yes | No | NA | Notes / Action Required | Upload File | ||
|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | ||
1 | Fire extinguishers are visible, accessible, and have a current service tag (within 12 months). | ||||||
2 | Emergency exit signs are illuminated and functional. | ||||||
3 | Exit doors open easily and are never locked or blocked from the inside. | ||||||
4 | Evacuation maps are posted in high-traffic areas. | ||||||
5 | Sprinkler heads have at least 18 inches (45 cm) of clearance from stored materials. |
Item | Yes | No | NA | Notes / Action Required | Upload File | ||
|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | ||
1 | Electrical panels have 36 inches (91 cm) of clear space in front of them. | ||||||
2 | Extension cords are used only for temporary tasks (not as permanent wiring). | ||||||
3 | Multi-plug adapters (daisy-chaining) are not in use. | ||||||
4 | No exposed wiring, frayed cords, or broken plugs are present. | ||||||
5 | GFCIs (Ground Fault Circuit Interrupters) are installed and tested near water sources. |
Item | Yes | No | NA | Notes / Action Required | Upload File | ||
|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | ||
1 | A current Safety Data Sheet (SDS) binder or digital database is accessible to all staff. | ||||||
2 | All chemical containers (including spray bottles) are clearly labeled with contents and hazards. | ||||||
3 | Flammable liquids are stored in approved fire-rated cabinets. | ||||||
4 | Secondary containment (spill pallets) is used for bulk liquid storage. |
Item | Yes | No | NA | Notes / Action Required | Upload File | ||
|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | ||
1 | Machine guards are in place and prevent hands from reaching "points of operation." | ||||||
2 | Emergency "Stop" buttons are red, mushroom-shaped, and functional. | ||||||
3 | Lockout/Tagout (LOTO) kits are available and used during maintenance. | ||||||
4 | Power tools are in good condition with safety triggers functioning. |
Item | Yes | No | NA | Notes / Action Required | Upload File | ||
|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | ||
1 | Heat Safety: Potable water, shade, and "cool-down" rest areas are provided (especially for non-climate-controlled zones). | ||||||
2 | Lighting: All work areas have adequate illumination (no flickering or dark zones). | ||||||
3 | Ergonomics: Adjustable chairs/workstations are available; heavy lifting is assisted by trolleys or lifts. | ||||||
4 | Psychosocial: Emergency contact numbers for mental health/EAP services are clearly posted. |
Item | Yes | No | NA | Notes / Action Required | Upload File | ||
|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | ||
1 | First aid kits are fully stocked (no expired items) and easily found. | ||||||
2 | Eye-wash stations (if required) are unobstructed and flushed weekly. | ||||||
3 | A list of trained First Aid Officers/Wardens is publicly displayed. |
Action Plan (For "No" or "Incomplete" Items)
Hazard Identified | Priority (H/M/L) | Assigned To | Due Date | ||
|---|---|---|---|---|---|
A | B | C | D | ||
1 | |||||
2 | |||||
3 | |||||
4 | |||||
5 |
Pro Tip: Don't just check the boxes. Talk to employees during the walk-through. They often know about the "hidden" hazards—like a machine that occasionally sparks or a floor that gets slippery only when it rains—that a visual check might miss.
Form Template Insights
Please remove this form template insights section before publishing.
To help you build a robust template, here is a breakdown of the core pillars of a workplace safety inspection. These insights focus on the functional purpose of each section and how they contribute to a high-standard operational environment.
The foundation of any inspection is the "shell" of the workspace. This section ensures that the physical layout supports movement without creating hazards.
This category focuses on the invisible hazards that can cause sudden, severe incidents.
This section is about the "Right to Know." Every person on-site should be able to identify a substance and understand its handling requirements instantly.
When things go wrong, the environment must "guide" the worker to safety.
Modern templates focus on how the worker interacts with their tools to prevent long-term strain.
If your workplace uses ladders, forklifts, or power tools, this section is critical.
Mandatory Questions Recommendation
Please remove this mandatory questions recommendation section before publishing.
In a high-standard workplace safety template, "mandatory" questions are those that address high-energy hazards or immediate life-safety concerns. These are the non-negotiables because their failure often leads to immediate injury or catastrophic equipment loss.
Here are the mandatory sections and the reasoning behind their inclusion:
To configure an element, select it on the form.