Sample Safety and Health Inspection Checklist
(Note: This is only a suggested format for an inspection checklist. This is not a comprehensive checklist. The safety committee should create a checklist that is specific to the safety and health issues and hazards in their workplace.)
Date of inspection: __________________________________________________
Area(s) inspected: _____________________________________________________
Inspection team members: (names)
Union members: _______________________________________________________
Management members:_________________________________________________
Fire/Chemical Releases/Emergency Evacuations
Is there a written Emergency Action Plan? Yes No
Have all workers received training about what do to in
an emergency ? Yes No
Have all workers received training about
evacuation procedures? Yes No
Are evacuation routes well marked? Yes No
Are all exits clearly marked and free of obstructions? Yes No
Electrical Hazards
Are electrical boxes covered? Yes No
Is all electrical equipment grounded (three-pronged plugs)? Yes No
Is electrical wiring, including all temporary wiring, regularly
inspected for breaks, fraying or other deterioration? Yes No
Are fuses and circuit breakers the right type and size
for the load? Yes No
Machine Guarding
Are the following areas guarded?
Moving machinery parts? Yes No
Points of operation? Yes No
Pinch points and nip points? Yes No
Chains, sprockets, gears, pulleys? Yes No
Rotating shafts? Yes No
Are band saw blades guarded above guide rollers? Yes No
Are machine guards only removed when the machine
has been locked/tagout out? Yes No
Are on/off switches/emergency stop buttons
easy to reach? Yes No
Walking/Working Surfaces
Are floors free from protruding nails, holes, ruts, loose or
uneven grates? Yes No
Is there adequate drainage to prevent water accumulation? Yes No
Are slip-proof mats or flooring materials used at work
stations? Yes No
Does the company ensure that fat, blood, pieces of meat or
other products that could cause slippery conditions are
regularly cleaned up and removed? Yes No
Lockout/Tagout
Are all machines/equipment capable of being locked out? Yes No
Are machines and equipment properly locked out when
maintenance, repair, unjamming, cleaning, adjusting
or making tool changes takes place? Yes No
Are all “authorized employees” trained in lockout/tagout? Yes No
Have all “affected employees” been trained in
lockout/tagout? Yes No
Ergonomics – Musculoskeletal Disorders (MSDs)
Are jobs evaluated for risk factors that can cause MSDs? Yes No
Are ergonomics controls used to reduce or eliminate the
risk factors that have been identified to cause MSDs ? Yes No
Is there a knife/scissor sharpening schedule in place? Yes No
Is a medical surveillance program in place for workers
who are suffering from early symptoms of carpal
tunnel syndrome or other MSDs? Yes No
Are adjustable work stands available to all workers who
need them? Yes No
Noise
Have noise surveys been conducted to identify high
noise areas? Yes No
Have all workers who are exposed to noise levels
greater than 85 dBA been identified? Yes No
Have workers exposed to high noise levels
(greater than 85 dBA) received the following:
Baseline hearing exams (conducted with 6 months of
exposure to high noise levels)? Yes No
Annual hearings exams (audiograms)? Yes No
Copies of their hearing exam results? Yes No
Free hearing protection (ear muffs or ear plugs)? Yes No
Training on effects of high noise exposure? Yes No
In areas of noise levels greater than 90 dBA, has the
company tried to use engineering controls
to reduce noise levels? Yes No
Heat
Are workers in high heat areas given time to adjust to
working in the heat (this takes about a week)? Yes No
Are fans used in hot areas? Yes No
Is local exhaust ventilation used to remove heat
and humidity? Yes No
Are workers and supervisors trained to recognized
symptoms of heat stress? Yes No
Are water and liquids made available to workers in
hot areas? Yes No
Are these workers allowed to drink water whenever
they need to? Yes No
Cold
Can coolers/freezers be opened from the inside? Yes No
Are workers provided adequate clothing (gloves,
hats, boots, freezer suits) when working in
cold work areas? Yes No
Are freezer tunnels guarded to prevent worker
exposure to blasts of cold air? Yes No
Are workers in cold areas protected from wind chill
caused by blowers, fans, air distribution systems? Yes No
Forklifts and Powered Industrial Trucks
Are walkways and passageways clearly marked for safe
operation of forklifts? Yes No
Are forklift and powered industrial truck operations
properly trained? Yes No
Are fork trucks equipped with overhead guards? Yes No
Are forklifts that need repair taken out of service? Yes No
Chemical Exposure
Have workers received training about
hazardous chemicals? Yes No
Is the training provided in a language workers
can understand? Yes No
Do all workers know how to get access to
Material Safety Data Sheets? Yes No
Are eye wash stations located in areas where caustic
chemicals are used? Yes No
Are eye wash stations in good working order? Yes No
Are workers working around hazardous chemicals
supplied with proper personal protective
equipment (PPE)? Yes No
Is the PPE provided at no cost to the worker? Yes No
Does the PPE fit properly? Yes No
Corrective Actions needed: ________________________________________________
Date actions will be taken: _________________________________________________