HEALTH & SAFETY COMMITTEE WORKPLACE INSPECTION FORM
This form is designed for use by the Health & Safety Committee to conduct workplace inspections aimed at ensuring a safe and healthy environment for all employees. The information gathered will help identify hazards, compliance issues, and areas for improvement.
INSPECTION OVERVIEW |
Date: | [April 12, 2050] |
Time: | |
Location: | |
Inspector: | |
Contact Info.: | |
SAFETY FACTORS |
Safety Factor | Observations | Action Required (if any) | Responsible Person |
Fire Safety | [Fire extinguishers are present and accessible.] | [Conduct a fire drill next month.] | [Name] |
Electrical Safety | | | |
Equipment Safety | | | |
Emergency Exits | | | |
Ventilation | | | |
HAZARD IDENTIFICATION |
Hazard | Priority | Action Required (if any) | Responsible Person |
[Slippery floor due to oil spill] | [High] | [Placed wet floor signs] | [Name |
| | | |
| | | |
| | | |
| | | |
Recommendation/Action | Priority Level (Low/Medium/High) | Responsible Person |
[Conduct additional safety training for all employees] | [High] | [Training Coordinator] |
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FOLLOW-UP PLAN |
Follow-up Activity | Scheduled Date |
[Conduct fire drill] | [April 30, 2050] |
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Thank you for your commitment to maintaining a safe workplace. If you have any concerns, please contact [Your Name] at [Your Company Number].
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