Sample form: Health and Safety Inspection sheet suitable for offices
Health and Safety Inspection checklist for officesSHE Representative: / Designated area:
Date of inspection: / Area Supervisor:
PREMISES
/ Yes / No1. / Walls, ceilings and floors – clean and in good repair
2. / Carpet tiles properly secured to floor
3. / Lighting adequate and free from glare; and all light fittings working
4. / Ventilation is adequate, i.e. not stuffy or smelly. Staff does not complain of headaches
5. / Housekeeping – everything neat, tidy and packed away
6. / Pollution – waste bins are provided and emptied daily
7. / Aisles and passages are clear of obstructions
8. / Stacking – heavy articles are placed at the base and lighter articles on top
9. / Furniture and equipment in a safe condition; wheeled chairs have no broken wheels; upholstery is not torn or damaged
10. / Window fittings and window panes are in good condition
11. / Doors, hinges and fittings are in good repair
12. / Hygiene – toilets/urinals are clean and in good working order. There are no shared cloth hand towels
13. / Hygiene – all kitchen/canteen areas are clean and hygienic
14. / Ladders and storage racks are adequate and in a safe condition
FIRE PROTECTION
/ Yes / No1. / All hand held fire extinguishers are in demarcated positions
2. / Extinguishers are not obstructed and can be removed from their brackets easily
3. / The pointer on the gauge shows “green”
4. / The fire extinguisher seals are intact
5. / The extinguishers are easily accessible (4.5kg so small people can handle them)
6. / All firefighting equipment has been serviced during the past year – check label
7. / Fire hose reels are easily accessible
8. / The fire hose connections do not leak
9. / The fire hoses are rolled neatly onto their drums
10. / Flammable liquids are adequately controlled and properly stored
11. / The emergency exit keys/devices are in place and these exits are unobstructed
12. / All staff know how to use fire equipment and raise the alarm in an emergency
ELECTRICAL
/ Yes / No1. / All wall plug fittings are undamaged and plugs fit securely in wall sockets
2. / Adapters are clear of heat discoloration and power cords free from damage
3. / All power cords and computer cables are neatly channelled and are away from water, walkways or similar hazards
4. / All power cords firmly and correctly fitted to plugs with no bare copper showing
5. / There are four devices or less per wall plug including the use of adaptors/multi-plugs
6. / Power tools correctly wired and earthed
7. / All kitchen and office appliance cables have intact insulation and are not damaged
EMERGENCY PREPAREDNESS
/ Yes / No1. / A qualified First Aider is available during normal working hours
2. / Provision is made for emergency care of staff working outside normal working hours
3. / First aid supplies meet the legal requirements with a checklist included in the box
4. / The location of the first aid box and name of the First Aider are clearly visible
5. / There is a record of items used from the first aid box, noting the name of the person requiring first aid
6. / A copy of the current emergency plan is available
7. / The emergency evacuation communication system is in order (PA system)
8. / All staff in the designated area know what to do in the event of an emergency
For each “No” response you must complete a deviation report. Submit this to your Supervisor.
Area / Deviation
Signature of Health and Safety Representative completing this form