Workplace Safety Audit Form
Welcome to the Workplace Safety Audit Form. This document aims to assess and enhance safety standards, fostering a secure environment for all employees. Your cooperation is appreciated.
I. General Information
Organization: | [Your Company Name] |
Location: | [Production Floor, Building 123] |
Date of Audit: | [Month Day, Year] |
Audited by: | [Name], [Job Title] |
II. Physical Environment
No. | Safety Aspect | Compliance (Yes/No) | Comments |
1 | Condition of Work Areas | [Yes] | [Clean and well-maintained.] |
2 | Equipment and Machinery Condition | | |
3 | Presence of Safety Signs and Labels | | |
4 | Lighting and Ventilation | | |
5 | Emergency Exit Accessibility | | |
III. Personal Protective Equipment (PPE)
No. | PPE Aspect | Compliance (Yes/No) | Comments |
1 | Availability and Proper Use of PPE | [Yes] | [PPE available; employees observed using PPE.] |
2 | Maintenance of PPE | | |
IV. Fire Safety
No. | Fire Safety Aspect | Compliance (Yes/No) | Comments |
1 | Presence and Condition of Fire Extinguishers | [Yes] | [PPE available; employees observed using PPE.] |
2 | Fire Exit Routes and Emergency Evacuation | | |
3 | Fire Alarm Systems | | |
V. Electrical Safety
No. | Electrical Safety Aspect | Compliance (Yes/No) | Comments |
1 | Condition of Electrical Equipment and Wiring | [Yes] | [No exposed wiring; equipment in good condition.] |
2 | Compliance with Electrical Safety Standards | | |
3 | Use of Grounded Outlets and Safety Measures | | |
VI. Chemical Safety
No. | Chemical Safety Aspect | Compliance (Yes/No) | Comments |
1 | Storage and Labeling of Chemicals | [Yes] | [Chemicals properly labeled and stored.] |
2 | Availability of Material Safety Data Sheets (MSDS) | | |
3 | Proper Use of Personal Protective Equipment | | |
VII. Machine Safety
No. | Machine Safety Aspect | Compliance (Yes/No) | Comments |
1 | Safeguarding Measures for Machinery | [Yes] | [Machine guards in place and operational.] |
2 | Employee Training on Machine Operation and Safety | | |
3 | Regular Maintenance of Equipment | | |
VIII. Workplace Ergonomics
No. | Ergonomics Aspect | Compliance (Yes/No) | Comments |
1 | Evaluation of Workstations for Ergonomic Considerations | [Yes] | [Workstations ergonomically designed; adjustable chairs provided.] |
2 | Training on Proper Lifting Techniques and Ergonomics | | |
IX. Training and Education
No. | Training and Education Aspect | Compliance (Yes/No) | Comments |
1 | Documentation of Safety Training Programs | [Yes] | [Training programs documented; schedule available.] |
2 | Employee Awareness of Safety Policies and Procedures | | |
3 | Records of Safety Drills and Exercises | | |
X. Incident Reporting and Investigation
No. | Incident Reporting and Investigation Aspect | Compliance (Yes/No) | Comments |
1 | Procedures for Reporting Accidents or Near Misses | [Yes] | [Reporting procedures communicated; forms available.] |
2 | Investigation Process for Root Causes of Incidents | | |
3 | Corrective Actions Implemented | | |
XI. Emergency Preparedness
No. | Emergency Preparedness Aspect | Compliance (Yes/No) | Comments |
1 | Availability and Condition of Emergency Response Equipment | [Yes] | [Emergency equipment (first aid kits, AEDs) inspected and accessible.] |
2 | Employee Awareness of Emergency Procedures | | |
3 | Regular Testing of Emergency Systems | | |
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