Industrial Services Safey Audit Form
Goodwill Industries of Wayne and Holmes Counties
Date
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Month
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Day
Year
Date
Location
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Auditor Signature
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Auditor
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First Name
Last Name
Audit Questions
Are workers wearing appropriate clothing and closed-toed shoes?
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Are the machine operators wearing bracelets, watches, etc., or wearing apparel subject to catching on or in the machines?
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Are material handlers working with wooden skids or metal banding wearing gloves?
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Do the supervisors maintain those gloves?
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Are hoses and electrical cords in traffic areas properly protected?
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Do workers know the specific safety rules for the machinery they are operating?
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Have new consumers/employees been instructed on the proper use of machinery and safety rules in the department?
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Are there any frayed or chafed electrical cords or air hoses?
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Are aisles free of accumulated materials or scrap?
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Are floors dry?
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Are work stations neat and orderly in appearance?
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Are all fire extinguishers properly charged, checked and logged, and available in a well-marked area?
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Do supervisors and Job Coaches know the proper use of fire extinguishers and their locations?
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Is the first aid kit, located in the south wall area of the contract area, stocked and easily accessible?
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Does the machinery have proper guards on them?
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Are three prong cords used and in good condition?
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Are all Safety Data Sheets (SDS) available at the supervisor's desk and work stations? Are they up to date?
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Is the Contracts/Industrial Services Safety manual available at the supervisor's desk?
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Is there eye protection required and used when necessary?
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Is there clear access to all electrical panels?
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Are chocks used to block trucks while loading and unloading at the docks?
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Are the Daily Vehicle Inspection Reports being completed for the box truck?
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Are pallet jacks and lift trucks properly maintained?
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Tow motor operators are wearing seatbelts?
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Are the forks down and brake set on the tow motors when not in use?
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Are chains used on the dock when doors are open?
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Are exits clearly marked, lights and doors working properly?
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Are flammable liquids stored in the proper cabinet?
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Is there excess paper and trash in the contract area.
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Are all machines grounded?
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Are all power tools in good working condition?
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Are all electrical plugs and outlets in good condition?
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Are the eye wash stations sanitary and in working order?
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Are all Emergency Lights in working order?
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Are all ladders in good repair?
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Are all restrooms clean and orderly?
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Is the lunchroom clean and free of debris and all trash cans covered with appropriate lids?
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Are tow motor inspection forms filled out for each day and are the tow motors in good working order with seat belts and fire extinguishers present?
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Are the electric pallet jack daily inspections being completed and logged?
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Are all new employees being trained on the electric pallet jacks (specifically Luk assemblers)?
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Are hazardous materials labeled correctly and disposed of?
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Lock out tag out procedures are at baler, compactor, electric pallet jack, staplers and shrink wrap machine?
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Is there a chemical inventory attached to the Hazardous communcation Plan? Are the SDS sheet available?
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Are the emergency lights checked each month and logs kept?
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Are the GFCI buttons on the electrical outlets checked each month and logs kept?
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Are there any combustibles stored near heating appliances?
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Are ceiling tiles in place and not broken or missing?
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Is the ceiling clearance of 24" in unsprinkled and 18" in sprinkled facilities observed?
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Use of powerstrips only when needed; no extension cords
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Are Exit aisles clear for unobstructed passage?
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Is the AED inspected and logged monthly?
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Are LUK turbine assemblers and material handlers wearing designated PPE (gloves, protective sleeves)?
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Safety Board - Safety Mission Statement and Safety Policy on the Board
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Yes
No
Safety Board - Safety and LP Team Members Posted
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Yes
No
Safety Board - Safety and LP Team Minutes Posted
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Yes
No
Safety Board - Blood and Bodily Fluid Spill Procedure Posted
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Yes
No
Safety Board - Emergency Procedures Posted
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Yes
No
Safety Board - Hazard Communication Plan with Chemical Inventory Posted
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Yes
No
Safety Board - Suggestion Program Posted
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Yes
No
Safety Board - OSHA 300 Form for Prior Year (2/1 to 4/30) Posted
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Yes
No
Maintenance Issues
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Recommendations for Areas Needing Improvement
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Actions Taken to Respond to Recommendations
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Submit
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