Palmer and Nold Safety Audit Form
Goodwill Industries of Wayne and Holmes Counties
Date
*
-
Month
-
Day
Year
Date
Location
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Auditor Signature
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Auditor
*
First Name
Last Name
Audit Questions
Floors are dry
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A stocked first aid kit is available
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Fire extinguishers are properly charged and tested and indicated on the attached card - and easily accessible.
*
Chemicals are properly stored and labeled
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Employees can explain the proper use of the fire extinguisher
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No smoking signs are posted and no one is observed smoking in non-smoking areas
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No cords or other trip hazards are in walkway.
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Grounded plugs are used on all electrical equipment.
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The building has a neat orderly appearance.
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Electrical panels are not blocked.
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Lunch area is free of food debris and trash containers conform with OSHA Standards (lids on all trash containers).
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Exit and Emergency lights properly working.
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The outside area is free of snow and ice
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Salt and snow shovels are available to the attendant
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Exit aisles are clear for unobstructed passage
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Are the emergency lights checked each month and logs kept?
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Are GFCI outlets checked each Month and logs kept?
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Are there any combustibles stored near heating appliances (furnace, water heater, heating vents)?
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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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A stocked first aid kit is available.
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Use of powerstrips only whenneeded; no extention cords for permanent means
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Posted MSDS Sheets.
*
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
*
Yes
No
Safety Board - Suggestion Program Posted
*
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
*
Actions Taken to Respond to Recommendations
*
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