Workplace Inspection Form

Please select the Housekeeping Zone:

Housekeeping Inspector *

Date of Inspection

Are notice boards readable and is the content current?

Yes
No
Not Applicable

Please describe the issues found?

Is the fabric of the area including any furniture and lighting in a good state of repair?

Yes
No
Not Applicable

Please describe the issues found?

Are passageways and thoroughfares clear of obstruction?

Yes
No
Not Applicable

Please describe the issues found?

Are extension leads used safely and is all cabling safely routed?

Yes
No
Not Applicable

Please describe the issues found?

Is waste properly managed?

Yes
No
Not Applicable

Please describe the issues found?

Is the area generally tidy and in a safe state?

Yes
No
Not Applicable

Please describe the issues found?

Are fire extinguishers present in their designated locations?

Yes
No
Not Applicable

Please describe the issues found?

Are all machinery guards in place and in good condition?

Yes
No
Not Applicable

Please describe the issues found?

Does the guard adequately prevent access to any moving parts during operation?

Yes
No
Not Applicable

Please describe the issues found?

Are start / stop controls easily identified and in working order?

Yes
No
Not Applicable

Please describe the issues found?

Are oil spills and other slips, trips, and falls hazards promptly cleaned up or removed

Yes
No
Not Applicable

Please describe the issues found?

Are raw materials, work in progress, and completed work stored correctly and safely?

Yes
No
Not Applicable

Please describe the issues found?

Is PPE being used where required and is it fit for purpose?

Yes
No
Not Applicable

Please describe the issues found?

Is all pallet racking in good condition?

Yes
No
Not Applicable

Please describe the issues found?

Is lifting equipment clearly marked to indicate its safe working load?

Yes
No
Not Applicable

Please describe the issues found?

Are suitable measures in place to prevent falls and falling objects?

Yes
No
Not Applicable

Please describe the issues found?

Are quantities of flammable / highly flammable chemicals kept to a minimum and correctly stored?

Yes
No
Not Applicable

Please describe the issues found?

Are chemical containers correctly labelled and are empties regularly removed?

Yes
No
Not Applicable

Please describe the issues found?

Other than ones that are in use are all chemicals stored in the COSHH cupboard?

Yes
No
Not Applicable

Please describe the issues found?

Where they show an indicator are all fire extinguishers correctly charged and do they show a test date of less that 1 year ago?

Yes
No
Not Applicable

Please describe the issues found?

Are all exits free from obstruction?

Yes
No
Not Applicable

Please describe the issues found?

Are any fire doors wedged open?

Yes
No
Not Applicable

Please describe the issues found?

Is there any evidence the smoking ban is not being followed?

Yes
No
Not Applicable

Please describe the issues found?

Is all electrical equipment in a good state of repair, are there sufficient sockets and is all equipment PAT tested and within date?

Yes
No
Not Applicable

Please describe the issues found?

Are first aiders identified?

Yes
No
Not Applicable

Please describe the issues found?

Is all first aid equipment well maintained, correctly stocked and in date

Yes
No
Not Applicable

Please describe the issues found?

Are toilet facilities in a clean and orderly condition?

Yes
No
Not Applicable

Please describe the issues found?

Is the area appropriately ventilated?

Yes
No
Not Applicable

Please describe the issues found?

Is soap available?

Yes
No
Not Applicable

Please describe the issues found?

Are towels or hand driers available?

Yes
No
Not Applicable

Please describe the issues found?

Are rest areas in a clean and orderly condition?

Yes
No
Not Applicable

Please describe the issues found?

Are any microwaves in a clean and orderly condition?

Yes
No
Not Applicable

Please describe the issues found?

Are any fridges in a clean and orderly condition?

Yes
No
Not Applicable

Please describe the issues found?

Is fresh and clean drinking water available?

Yes
No
Not Applicable

Please describe the issues found?

Please add any additional comments in this section:

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