General Safety Inspection Form

Survey notes on reverse page.                                                                                  GOOD        POOR

TRIP/SLIP/FALL HAZARDS                                                                                 

            - Area is free of trip/fall/slip hazards (carpets, holes, obstacles).                        _______     _______

            - Area is free of loose wires, computer cables and telephone cords.                  _______     _______  

            - Area is free of standing liquids.                                                                       _______     _______

FIRST AID KITS

            - Kit contains only bandages, gauze, tape etc. (No oral or topical medications.  Refer to

               Policy SY-21 for more information.)                                                              _______     _______

            - Is/are readily accessible.                                                                                 _______     _______

            - Signs identify location of kit.                                                                           _______     _______

LOADING DOCKS

            - Pallets are not stacked on end.                                                                        _______     _______

            - Compressed gas cylinders are properly secured.                                             _______     _______

_____________________________________________________________________________________

FIRE DOORS

            - Should be closed at all times.                                                                          _______      _______

MEANS OF EGRESS

            - Exit signs are present and illuminated.                                                              _______      _______

            - Exits, floors, hallways and aisles are unobstructed.                                          _______      _______

            - Stairwells/corridors are not used for storage/free of furniture, equipment.         _______      _______

            - Lighting is operable for all means of egress.                                                     _______      _______

            - Bicycles are not present indoors.                                                                     _______      _______

HOUSEKEEPING

            - No excess storage of combustibles (boxes, papers, files etc.) is present.          _______      _______

FIRE EXTINGUISHERS

            - Last inspection is within 12 months.                                                                _______      _______

            - Extinguisher is mounted to the wall.                                                                 _______      _______

            - Extinguisher is in open view and accessible.                                                     _______      _______

FIRE ALARM DEVICES

            - Pull stations are visible and unobstructed.                                                        _______      _______

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WIRING

            - Wiring is not frayed or altered.                                                                        _______      _______ 

            - Outlets do not possess more than one multiplug adapter.                                 _______      _______

            - Outlet faceplates are present and intact.                                                          _______      _______

            - Switch faceplates are present and intact.                                                         _______      _______

            - Cords and plugs are not altered.                                                                     _______      _______

            - Cords are not running under carpets, desk legs, walkways etc.                        _______      _______

ELECTRICAL PANELS      

            - Panel covers are present.                                                                                _______      _______

            - Panels are visible and readily accessible (3 feet clear floorspace).                    _______      _______

_____________________________________________________________________________________

MACHINE GUARDING

            - All pinchpoints are properly guarded.                                                              _______      _______

            - All pulleys, belts and gears are properly guarded.                                            _______      _______

            - All guards are in place (fans, centrifuges, drive belts etc.).                                _______      _______