County of Placer

Rev. Nov. 2010

COUNTY OF PLACER

SAFETY AND HEALTH

INSPECTION CHECKLIST

OFFICE WORK ENVIRONMENTS

Department/Division:______

Address/Location:______

Date of This Inspection:______Date of LastInspection:______

Conducted by (Please Print)______Title:______

Signature: ______

INSTRUCTIONS

The Placer County Injury and Illness Prevention Program (IIPP) requires managers/supervisors to conduct regular safety inspections of areas under their control. This safety inspection checklist for Office Work environments has been developed to assist departments in fulfilling that responsibility.

This checklist has a very comprehensive scope; not all operations will exist in all environments. If a particular operation or item does not exist in your area, please note this on the inspection form by one of the following methods:

Write “n/a” in the comment section for that item.
Draw a diagonal line through the item /description(s) for the item or for the entire section if not applicable to your operations.

Departments are encouraged to modify and customize this form to fit their operations. The original Word file can be obtained from your Department Safety Representativeor at V:\ Risk Management\Safety\SAFETY-HEALTH INSPECTION CHECKLIST revised 2010. If your worksite has operations, equipment, or processes not covered by this checklist, Risk Management can assist you in developing an inspection checklist tool for your department.

This checklist is designed so that each applicable inspection item should be answered with a “yes”. Inspected items which are checked “no” require corrective action.

Corrections to noted problems may be accomplished by:

(1) Fixing it yourself if it is safe for you to do so.

(2) Issuing a work order to Facilities Services to repair an item.

(3)Safety training/retraining.

If these methods cannot correct the problem, contact Risk Management for assistance.

After completion of the inspection, all safety inspection checklists and documentation (i.e., notes, work orders, training sign-in sheets, etc.) should be kept on file by the department for at least three (3) years. Questions regarding safety inspections can be directed to Risk Management at (530) 886-2600.

GENERAL OFFICE /

YES

NO

/ COMMENTS
Documentation of safety inspections and corrective actions are being maintained for 3 years by this Department.
CAL/OSHA “Safety and Health Protection on the job poster is posted in a conspicuous location frequented by employees (i.e. safety bulletin board, break room, lunchroom, copy room, etc.)
Workers’ Compensation Poster is hung in a conspicuous location.
Safety “Tip Line” poster is hung in a conspicuous location.
Safety Hazard Report Forms are made available to all employees and posted in a conspicuous location.
Our Department’s written Injury and Illness Prevention Program is available to all employees and all employees have been trained on the IIPP.
Work spaces, passageways, storerooms, closets, restrooms and service rooms kept clean and orderly.
Storage areas are free from accumulation of materials that constitute hazards from tripping, fire, explosion, pests or mold.
Floors, stairs, and handrails are clean, dry, and in good repair.
Wet mopped floors or liquid spills are guarded and posted with appropriate signs or barriers until corrected.
Aisles/exit corridors are clear to a minimum 36 inch width.
Work spaces, aisles, stairways, walkways and exits are well lighted and clear of obstructions that could cause injury due to tripping, slipping or falling?
Electrical panels are clear and accessible to a minimum distance of 36 inches.
Exit ways to the aisles and exit corridors(i.e., from behind desks, from cubicles, etc.) are a clear-28 inch minimum width.
Furniture and other office equipment are positioned so there are no protruding parts or tripping hazards.
Chairs and other office furniture in good condition.
Shelves not overloaded; heavy items stored on lowest shelves.
Desk and file cabinet drawers and bookcase doors are closed when not in use.
Carpets and rugs secure and free of cuts, wrinkles or other trip hazards.
Cords (electrical, computer, telephone) secured and do not present a tripping hazard.
Entrance mats for wet weather are in good condition and effective.
Portable stairs, step stools, etc. are in good condition.
Paper cutters are in closed position when not in use; blade spring functioning/guarded; other sharp objects are properly stored.
There is a current certificate of operation or notice stating the location of the certificate posted in the elevator. (Passenger elevators must be certified by the State of California on a yearly basis.)
Other safety and health issues listed below?
EMERGENCY RESPONSE / YES / NO / COMMENTS
Emergency telephone numbers for fire and other emergency services are posted, available at each telephone and listed in our emergency action plan.
Evacuation training/drills are conducted at least yearly and documented. Records of training are maintained in the department for 3 years.
Updated, written Emergency Evacuation Plan posted and available to all employees.
First aid kit is in place, fully stocked, and checked on a monthly schedule. Location of first aid kit is known to all employees.
Trained first aid providers are available in this department.
Sufficient number of exits provided to permit prompt escape in case of an emergency.
Exit signs are provided and all doors that may be mistaken as an exit are appropriately marked with a sign; “Not An Exit”.
Designated exits are illuminated; signs are of proper size and visible from all directions.
Locks, latches or other devices do not impede free and unobstructed egress (no nonsense hardware, one continuous motion to open the door).
Signage on doors which may open into work areas or hallways state “Open Door Slowly”.
Filing cabinets, storage cabinets, and wall lockers (72” or taller) are properly anchored to prevent tipping so as not to impede evacuation.
Wall lockers, filing cabinets and other tall equipment are free of objects or materials that could fall.
Other Emergency Response issues listed below?

FIRE PREVENTION

YES

NO

COMMENTS

Is there a written fire prevention plan in operation and kept in your workplace and made available for all employees to review?
Does your fire prevention plan include all of the following: (1) proper handling and storage of mat-erials that pose a fire hazard (2) control of potential ignition sources, such as welding or smoking (3) the names or job titles of those responsible for the prevention and control of fires and flammable or combustible waste materials (4) employee training program for fire prevention and emergencies to include use of portable fire extinguishers.
There is an effective supervised signaling system used to alert employees in case of fire or other emergency (i.e., building fire alarm, air horn, intercom system or voice signaling).
All employees have received instruction on building fire alarm or other type signaling system and evacuation procedures.
Fire extinguishers have a current inspection tag (must be serviced on an annual basis).
The back of each fire extinguisher tag is initialed monthly indicating it was visually inspected.
Fire/evacuation drills are conducted at least annually and documented.
Portable fire extinguishers are located with 75 feet of either direction, are accessible, mounted, and are visible from several directions.
Supplies, materials, or equipment are not piled closer than 18 inches from the sprinkler heads, or 24 inches from the ceiling.
Fire doors are not propped or left open unless they are on self closers tied to the building alarm system.
Other Fire Prevention issues listed below?
HEALTH AND ENVIRONMENT / YES / NO / COMMENTS
All containers are labeled as to their content (i.e., cleaning products).
Employees are aware of the hazards of various chemicals in the area and material safety data sheets are available.
All employees who may be exposed to hazardous substances have been trained under our department’s written Hazard Communication Program and records are maintained.
All employees are required to wear appropriate personal protective equipment when handling recog-nized hazardous materials.
Employees utilizing personal protective equipment have been trained in its proper use.
Heating, ventilation and air conditioning systems are in proper operating condition.
There is no water intrusion or leaks in the work area.
There is no visible mold in the work area.
Other Health and Environmental issues listed below?

ELECTRICAL/LIGHTING

YES

NO

COMMENTS

36 inches of clear space in front of electrical panels; circuit breaker panels; breakers labeled.
Electrical rooms are free of storage.
All electrical outlets are covered with faceplates.
Extension cords and plug adapters are NOT per-mitted to be used in any workplace (multiple plug strip with 15-20 amp circuit breakers are acceptable).
There are no electrical cords running through a doorway.
All electrical cords are in good repair a free of fraying.
Portable hot plates, coffee pots and other electrical appliances are authorized and controlled in a safe manner.
Portable electric heaters are equipped with automatic shut-off switches when tipped over accidentally.
Light diffusers are properly secured to prevent from falling.
Ceiling tiles/panels in place and secured.
Light tubes covered and protected from falling and accidental contact.
Other Electrical/Lighting issues listed below?

ERGONOMICS

/ YES / NO /

COMMENTS

Have all employees been provided a chair that is properly fitted and fully adjustable?
Have employees been provided fully articulating keyboard trays where needed?
Is the pointing device (i.e., mouse) positioned level and adjacent to the keyboard?
Is the monitor centered and the top line of print at or just below eye level (or lower if EE is using corrective lenses)?
Have employees been provided copy holders where needed?
Have employees been provided telephone headsets if necessary?
Have employees been provided footrests where necessary?
Are there sufficient rest breaks, in addition to the regular rest breaks, to relieve stress from repetitive motion tasks?
Are all pieces of furniture adjusted, positioned and arranged to minimize strain on all parts of the body?
Employees have been provided training on computer workstation ergonomics.
Other Computer Workstation Ergonomic issues listed below?
WORKPLACE SECURITY / YES / NO / COMMENTS
Exterior doors and windows closed and locked during non-business hours.
Lighting is adequate both inside and outside of the facility.
Shrubs and bushes cut back from entrances/exits.
Card key or controlled access doors are not propped open or opened for unauthorized persons.
Is there a plan to deal with aggressive behavior as part of your emergency action plan?
Other Workplace Security issues listed below?
OTHER HAZARDS IDENTIFIED

Rev. Nov. 2010