Palmer and Nold Safety Audit Form
Goodwill Industries of Wayne and Holmes Counties
Date
*
-
Month
-
Day
Year
Date
Location
*
Auditor Signature
*
Auditor
*
First Name
Last Name
Audit Questions
Floors are dry
*
A stocked first aid kit is available
*
Fire extinguishers are properly charged and tested and indicated on the attached card.
*
Chemicals are properly stored and labeled
*
Employees can explain the proper use of the fire extinguisher
*
No smoking signs are posted and no one is observed smoking
*
No extension cords, damaged electrical cords are in walkway.
*
Grounded plugs are used on all electricalequipment.
*
The building has a neat orderly appearance.
*
Electrical panels are not blocked.
*
Lunch area is free of food debris and trash containers conform with OSHA Standards (lids on all trash containers).
*
Fans are properly guarded when in use.
*
Exit and Emergency lights properly working.
*
The outside area is free of snow and ice
*
Salt and snow shovels are available to theattendant
*
Exit aisles are clear for unobstructed passage
*
Is there a chemical inventory attached to the Hazardous Communication Plan?
*
Are the emergency lights checked each month and logs kept?
*
Are the self test buttons on the light plugs check each Month and logs kept?
*
Are there any combustibles stored near heating appliances (furnace, water heater, heating vents)?
*
Are ceiling tiles in placeand not broken or missing?
*
Is the ceiling clearance of24" in unsprinkled and 18" in sprinkled facilities observed?
*
A stocked first aid kit is available.
*
Use of powerstrips only whenneeded; no extention cords
*
Posted MSDS Sheets.
*
Are Exit aisles clear forunobstructed passage?
*
Safety Board - Safety Mission Statement and Safety Policy on the Board
*
Yes
No
Safety Board - Safety and LP Team Members Posted
*
Yes
No
Safety Board - Safety and LP Team Minutes Posted
*
Yes
No
Safety Board - Blood and Bodily Fluid Spill Procedure Posted
*
Yes
No
Safety Board - Emergency Procedures Posted
*
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
*
Yes
No
Maintenance Issues
*
Recommendations for Areas Needing Improvement
*
Actions Taken to Respond to Recommendations
*
Submit
Should be Empty: