WORKPLACE INSPECTION CHECKLIST
Department/Area:
Assessors: (Name and Signature)
Date:
ADMINISTRATION AREA
Checklist
Issue = No
(Action
Must be
Taken)
1.
GENERAL OSH
1.1
Is the OSH Representative known
to all caregivers?
Yes
No
1.2
Is the OSH Representative involved
in the investigation of hazards /
incidents as required?
Yes
No
N/A
1.3
Has there been any incidents of
violence / abuse in the workplace
since the last audit?
Yes
No
N/A
1.4
If yes to 1.3, have they been
documented,
investigated
and
followed up?
Yes
No
N/A
1.5
Is the first aid box available and
stocked as per list?
Yes
No
N/A
1.6
Are duties rotated to minimize
postural stress (if required)?
Yes
No
N/A
Revised April 2007
Hazard Identified & Risk
Rating – Low/Medium/High/
Extreme A/Extreme B
(Provide specific details Risk Matrix on last page)
Recommended or possible
corrective Action
(hierarchy of controls – elimination,
substitution, engineering,
administration, PPE)
Page 1 of 8
Person(s) responsible for
ensuring corrective action is
complete – Manager is
responsible but may require
assistance from caregivers
Date
Complete
Next Review: April 2010
Checklist
Issue = No
(Action
Must be
Taken)
2.
EMERGENCY RESPONSE / FIRE
2.1
Are all access and egress points
clear of obstructions?
Yes
No
N/A
2.2
Are appropriate fire extinguishers
visible and clear of obstructions?
Yes
No
N/A
2.3
Are all fire exit routes clearly signed
and illuminated?
Yes
No
N/A
2.4
Have extinguishers /equipment
been serviced in the last 12
months?
Yes
No
N/A
2.5
Is the Emergency Evacuation
Procedure clearly displayed and
highlighting the assembly point?
Yes
No
N/A
2.6
Have all caregivers completed
annual fire safety / emergency
procedures
training?
Yes
No
N/A
2.7
Do caregivers know the alert and
evacuation tones?
Yes
No
N/A
2.8
Are caregivers aware
evacuation procedures?
the
Yes
No
N/A
2.9
Are fire safety signs displayed, ie.
Signs above fire extinguishers?
Yes
No
N/A
Revised April 2007
of
Hazard Identified & Risk
Rating – Low/Medium/High/
Extreme A/Extreme B
(Provide specific details Risk Matrix on last page)
Recommended or possible
corrective Action
(hierarchy of controls – elimination,
substitution, engineering,
administration, PPE)
Page 2 of 8
Person(s) responsible for
ensuring corrective action is
complete – Manager is
responsible but may require
assistance from caregivers
Date
Complete
Next Review: April 2010
Checklist
Issue = No
(Action
Must be
Taken)
Hazard Identified & Risk
Rating – Low/Medium/High/
Extreme A/Extreme B
(Provide specific details Risk Matrix on last page)
3.
GENERAL HOUSEKEEPING AND PHYSICAL HAZARDS
3.1
Are the floors in good condition –
i.e. not slippery or unsafe, floor
coverings in good condition
Yes
No
N/A
3.2
Are work areas, storerooms, and
corridors free from clutter and
obstructions?
Yes
No
N/A
3.3
Is the work area free from any
protruding, sharp, exposed objects
or low overhead structures?
Yes
No
N/A
3.4
Are cupboards stable – e.g.
attached to the wall or floor to
prevent them from falling over?
Yes
No
N/A
3.5
Is lighting adequate for the work
performed ie is lighting working
effectively?
Yes
No
N/A
3.6
Is the work area free from any
sources of excessive noise in the
immediate work area?
Yes
No
N/A
3.7
Does the temperature appear to be
adequate?
Yes
No
N/A
Revised April 2007
Recommended or possible
corrective Action
(hierarchy of controls – elimination,
substitution, engineering,
administration, PPE)
Page 3 of 8
Person(s) responsible for
ensuring corrective action is
complete – Manager is
responsible but may require
assistance from caregivers
Date
Complete
Next Review: April 2010
Checklist
Issue = No
(Action
Must be
Taken)
4.
ELECTRICAL HAZARDS
4.1
Are cords/plugs safe and not frayed
or broken?
Yes
No
N/A
4.2
Are cords safe and not presenting a
trip hazard?
Yes
No
N/A
4.3
Are power points safe? – (double
adaptors must not be used)
Yes
No
N/A
4.4
Is electrical equipment tested within
the scheduled timeframe?
Yes
No
N/A
4.5
Are all hand operated electric tools /
equipment used fitted with a
Residual Current device /safety
switch?
Yes
No
N/A
4.6
Are all light fittings and switches
clean and in good repair?
Yes
No
N/A
5.
AMENITIES
5.1
Are washrooms/toilets clean?
Yes
No
N/A
5.2
Are rubbish bins available and
covered?
Yes
No
N/A
Revised April 2007
Hazard Identified & Risk
Rating – Low/Medium/High/
Extreme A/Extreme B
(Provide specific details Risk Matrix on last page)
Recommended or possible
corrective Action
(hierarchy of controls – elimination,
substitution, engineering,
administration, PPE)
Page 4 of 8
Person(s) responsible for
ensuring corrective action is
complete – Manager is
responsible but may require
assistance from caregivers
Date
Complete
Next Review: April 2010
Checklist
6.
EQUIPMENT
6.1
Is all equipment, tools,
furniture in good repair?
Issue = No
(Action
Must be
Taken)
and
Hazard Identified & Risk
Rating – Low/Medium/High/
Extreme A/Extreme B
(Provide specific details Risk Matrix on last page)
Recommended or possible
corrective Action
(hierarchy of controls – elimination,
substitution, engineering, administration,
PPE)
Person(s) responsible for
ensuring corrective action is
complete – Manager is
responsible but may require
assistance from caregivers
Date
Complete
Yes
No
N/A
6.2
Are tags (out of service/danger)
used on faulty equipment?
Yes
No
N/A
6.3
Are all trolleys in good working
order (ie wheels moving freely, no
sharp edges)?
6.4 Is equipment stored safely?
Yes
No
N/A
Yes
No
N/A
6.5
Are all fridges closing / sealing
effectively?
Yes
No
N/A
7.
BIOLOGICAL HAZARDS AND WASTE
7.1
Are hand washing agents at all
hand basins/sinks and working
appropriately?
Yes
7.2 Are paper towels and waste bins at all
Yes
hand basins/sinks
No
N/A
No
N/A
7.3
Are hand lotions readily available?
Yes
No
N/A
7.4 Is waste correctly segregated (as per
policy)?
Yes
No
N/A
Revised April 2007
Page 5 of 8
Next Review: April 2010
Checklist
Issue = No
(Action
Must be
Taken)
8.
CHEMICAL SAFETY
8.1
Is there a Hazardous Substance
manual for the department?
Yes
No
N/A
8.2
Are current MSDS available in the
department for all chemicals?
(expire every 5 years)
Yes
No
N/A
clearly
Yes
No
N/A
8.4
Have risk assessments been
conducted
for
hazardous
substances / dangerous goods
used?
Yes
No
N/A
8.5
Have caregivers received training
regarding the use, disposal, and
cleaning of spills for hazardous
substances / dangerous goods?
Yes
No
N/A
8.6
Is
there
written safe work
procedures available for the safe
use of chemicals?
Yes
No
N/A
8.7
Are dangerous or hazardous
substances stored appropriately?
(i.e. only with other compatible
chemicals)?
Yes
No
N/A
8.8 Is
the
necessary
protective
equipment available and used?
Yes
No
N/A
8.9
Yes
8.3 Are chemical
labeled?
containers
Are spill cleanup kits available where
needed and spill procedures displayed?
Hazard Identified & Risk
Rating – Low/Medium/High/
Extreme A/Extreme B
(Provide specific details Risk Matrix on last page)
Recommended or possible
corrective Action
(hierarchy of controls – elimination,
substitution, engineering,
administration, PPE)
Person(s) responsible for
ensuring corrective action is
complete – Manager is
responsible but may require
assistance from caregivers
Date
Complete
No
N/A
Revised April 2007
Page 6 of 8
Next Review: April 2010
Checklist
Issue = No
(Action
Must be
Taken)
9.
MANUAL HANDLING / STORAGE
9.1
Have risk assessments been
conducted on hazardous manual
handling tasks?
Yes
No
N/A
9.2
Have caregivers been provided with
manual handling training?
Yes
No
N/A
9.3
Are heavy items or frequently used
items stored properly – between
mid-thigh and shoulder height?
Yes
No
N/A
9.4
Are benches at working height of
task being performed?
Yes
No
N/A
9.5
Are trolleys available and used to
transport items / equipment?
Yes
No
N/A
9.6
Are trolleys loaded appropriately
(eg. Not stacked above head high?)
Yes
No
N/A
9.7
Are step-ladders/shelf steps used to
access items stored on high
shelves?
Yes
No
N/A
9.8
Are step-ladders/shelf steps used in
good repair?
Yes
No
N/A
Revised April 2007
Hazard Identified & Risk
Rating – Low/Medium/High/
Extreme A/Extreme B
(Provide specific details Risk Matrix on last page)
Recommended or possible
corrective Action
(hierarchy of controls – elimination,
substitution, engineering,
administration, PPE)
Page 7 of 8
Person(s) responsible for
ensuring corrective action is
complete – Manager is
responsible but may require
assistance from caregivers
Date
Complete
Next Review: April 2010
Other Comments
Consequence
Likelihood
Critical
Major
Moderate
Minor
Negligible
Almost Certain
Extreme A
Extreme A
Extreme B
High
High
Likely
Extreme A
Extreme A
High
High
Medium
Occasionally
Extreme A
Extreme B
High
Medium
Low
Unlikely
Extreme B
Extreme B
Medium
Low
Low
Rare
Extreme B
Extreme B
Medium
Low
Low
Manager/Supervisor Signature
Date
Received by OSH Practitioner
Date
Completed Workplace Inspection Records are to be sent to
the OSH Practitioner Manager to ensure outstanding items are completed
Revised April 2007
Page 8 of 8
Risk Pro Hazard Number:
Date entered:
Next Review: April 2010