Facility Inspection Checklist
Weekly
Location #
*
Location Name
*
Date
*
-
Month
-
Day
Year
Date
District Manager's Email:
*
dm@pci-sf.com
Regional Manager Email
*
example@example.com
General Manager Email
*
example@example.com
Inspected By: (your email)
*
yourname@pcila.com
Number of Employees at this site?
*
PLEASE NOTE CORRECTIVE ACTIONS TO BE TAKEN
PARKING FACILITY / LOT
*
Rows
YES
NO
N/A
All exits/stairwells clearly marked
Liability disclaimers posted - must match ticket disclaimers
Lot surface in good condition - pot holes/grease/drainage, etc.
Wheel stops are in good condition
Stall striping clear and defined
Directional arrows and mirrors present and clear
Condition of pedestrian walkways - well striped, no trip hazards
Presence of traffic flow indicators and signs
Sufficient lighting
Fixtures in good condition
Gates in good operating condition (protection padding/sponges on gates)
Garage has good ventilation
All areas clear of construction materials, ladders, other slip, trip, and fall hazards
Curbing around booth level
Notes
STAIRWELLS
*
Rows
YES
NO
N/A
Doors propped open
Doors to stairwell clean & operating
Doors locked/closed from outside
Steps clear of obstacles
Non-slip strips on stairs
Hand rails clean & sturdy
Sufficient lighting
Exit signs to stairwells (per City or Local codes)
Notes
ELEVATORS
*
Rows
YES
NO
N/A
Liability signs present/near elevator area
Elevators operating properly
Leveling of elevators to floor
Sufficient lighting
Door operating properly
Alarm operating properly
Phone present
Layout map to nearest stairwell
Notes
OFFICE AREA
*
Rows
YES
NO
N/A
Doors propped open
“No Smoking” signs displayed
Doors secure/locks in good working condition
Copy of Injury & Illness Prevention Program/Safety Manual
Material Safety Data Sheets for Chemicals
Job safety hazard analysis information present
Required Wage & Hour/Workers’ Compensation postings:
i. Medical Clinic Poster
ii. OSHA 300 Log (locations with 11 or more employees)
iii. Safety Rules
iv. Hazard Awareness Notification
v. Workers’ Compensation DWC7 & MPN
vi. Disclaimer for Sponsored activities
vii. Safety Talk Logs
Notes
LAVATORY AND BREAK ROOM
*
Rows
YES
NO
N/A
Adequate supplies of paper, soap, paper towels, etc.
Water available for washing & drinking
No smoking signs are displayed
Cooking appliances operating properly
Notes
EMPLOYEE ACCIDENT/INJURY – WORKERS’ COMPENSATION ALL FORMS MUST BE SUBMITTED TO CORPORATE OFFICE IMMEDIATELY FOLLOWING ANY INDUSTRIAL INJURY
*
Rows
YES
NO
N/A
Medical Treatment Authorization/Medical Facility Location
Checklist & Current Forms for Workers’ Compensation
DWC7, DWC1 & Employee Statement
Form 5020, Supervisor’s Report & contact Information
Notes
VEHICLE ACCIDENT/VALET INCIDENT REPORTING – AUTO & GKLL ALL FORMS MUST BE SUBMITTED TO CORPORATE OFFICE IMMEDIATELY FOLLOWING ANY ACCIDENT OR INCIDENT
*
Rows
YES
NO
N/A
Accident Report Form
Standard Insurance Claim Information Form
Attendant’s Report Form
Manager’s Report Form
Notes
PUBLIC LIABILITY INCIDENTS/SLIP & FALL – GENERAL LIABILITY ALL FORMS MUST BE SUBMITTED TO CORPORATE OFFICE IMMEDIATELY FOLLOWING ANY ACCIDENT OR INCIDENT
*
Rows
YES
NO
N/A
Incident Report Form
Attendant’s Report Form
Manager’s Report Form
Notes
BOOTH INSPECTIONS
*
Rows
YES
NO
N/A
Electrical cords in good condition
Chair/stool in proper working order, supportive, stable
Heating & air conditioning system working properly
“NO SMOKING” policy posted and observed
Doors and windows operational/locks working
Fire extinguisher with up to date inspection tag
Chemicals in booth stored properly
Material Safety Data Sheets available for the chemicals
Sufficient lighting, visibility/mirrors
Driveway surrounding booth free of oil & obstructions
Notes
EQUIPMENT
*
Rows
YES
NO
N/A
Operation of gate arms
Ticket dispenser closed & locked
Gate arm box closed & locked
Gate arm padding present along entire arm and in good condition
Gate arm caution signs present
Key boxes closed & locked
Notes
EMERGENCY EQUIPMENT
*
Rows
YES
NO
N/A
Emergency Evacuation Plan Posted
Condition of fire extinguisher in good condition/inspection up to date
First Aid Kit supplies available and up to date
Personal protective equipment (PPE) is in good condition and used:
i. Footwear
ii. Safety Belts
iii. Back Belts
iv. Gloves
v. First Aid Kit
vi. Glasses/Goggles
Notes
SIGNAGE
*
Rows
YES
NO
N/A
“How am I driving?” signs posted in shuttle & valet areas
Not responsible for “Lost Articles” sign, near entrance to garage
Liability disclaimer at entrances
Caution pedestrian walkway signs
Caution “THIS IS NOT A WALKWAY” on gate arm
Caution “THIS IS NOT A WALKWAY” on ground by gate
Caution “THIS IS NOT A WALKWAY” prior to booth exit
Caution “SLIPPERY SURFACE” sign
“NOT RESPONSIBLE FOR ITEMS LEFT IN THE CAR” sign
Speed limit signs present
Notes
WVPP
*
Rows
YES
NO
N/A
Emergency telephone numbers programmed into the company telephone?
The entrance to the building, the parking lot and bus yard is easily seen from the street and free of heavy shrub growth.
Lighting is bright in outside, parking, and outside building entrances to see clearly [not broken or out]
All exterior walkways are visible to security personnel.
Windows and views outside and inside are clear of advertising or other obstruction.
Exit doors are opened only from the inside to prevent unauthorized entry [doors are not propped open]
Indoor lighting adequate to see clearly in indoor areas [not broken or out]
Security cameras or closed-circuit TV are positioned in high-risk areas and function properly [not broken]
Security mirrors – convex mirrors positioned in high-risk areas [not broken or misaligned]
Secured entry buzzers are functional.
Floor plans are posted showing building entrances and exits.
There are no broken windows or door locks.
Security devices (locks, cameras, alarms, etc.) are tested and operational.
Notes
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