Example Workplace Health & Safety Inspection Form (General/Offices)
Note only items !ith the potential to affect health an" safety sho#l" $e recor"e"
on this form% non&safety maintenance items sho#l" $e recor"e" separately'
DATE............................................. LOCATION /
AREA .......................................................
ASSESSORS ..........................................................................................................
..............
Health an" safety iss#e In"icate if satisfactory or
note "efects
(ction $y
!hom &
!hen
)omplete"
*ate/initials
+' Ho#sekeepin,
(re !orkplaces ti"y% !ell
maintaine" an" materials
safety store"- )onsi"er..
Stora,e of materials
(avoid storage in gangways and
fire evacuation routes; heavy
items and liquids should not be
stored above shoulder height)
)on"ition of traffic ro#tes
an" entrances / exits
Are pedestrian routes clear?
Avoid tripping or slip hazards
(such as trailing cables, frayed
carpets, loose tiles, spilt
liquids)?
/aintenance an" con"ition of
the $#il"in, str#ct#re
Eg condition of walls,
windows, steps, stairs,
handrails; is shelving fi!ed in
place?
:
Health an" safety iss#e In"icate if satisfactory or
note "efects
(ction $y
!hom &
!hen
)omplete"
*ate/initials
0' En1ironmental )on"itions
(re con"itions satisfactory-
"ighting
#eating
$entilation
%oise
2' /an#al Han"lin,
I"entify any ha3ar"o#s
man#al han"lin, acti1ities'
#ave ris&s been assessed?
' ( %
#ave regular handlers been
trained in safe lifting?
' ( %
#ow can ris&s be reduced
further?
4' *esi,n & 5se of *isplay Screen E6#ipment (*SE) Workstations
(re staff !orkstations
er,onomically "esi,ne"-
)onsi"er.'
"ayout of wor&stations,
adequate space, suitability of
furniture?
)eating ( posture of *)E
users(refer to Appendi! +)
,s screen image clear
Are lighting levels -.? Any
glare (blinds provided)?
#ave eye tests been offered to
*)E users, are sufficient rest
brea&s ta&en?
Ha1e *SE !orkstations $een
assesse"- 7ES / NO
*ate of last assessment/
Health an" safety iss#e In"icate if satisfactory or
note "efects
(ction $y
!hom &
!hen
)omplete"
*ate/initials
8' Welfare Facilities
(re !elfare facilities s#ita$le
an" s#fficient-
.itchens ( canteen ( rest areas
0oilets
1ashing ( changing facilities
9' First (i" Facilities
(re n#m$ers of :raine" First
(i"ers a"e6#ate-
Are there sufficient 2irst Aid
.its?
Are they well stoc&ed and their
location &nown? (who
inspects?)
;' Safety Si,ns
Are safety and fire signs
adequate and in good
condition?
3an signage be improved?
<' Work !ith Ha3ar"o#s S#$stances (!here applica$le)
Ha1e )OSHH (ssessments
$een pro"#ce" an" #p"ate"-
7 / N
Are controls implemented?
Storage
#andling ( use
*ust or fume e!traction 4
tested?
=' >ersonal >rotecti1e E6#ipment >>E (!here applica$le)
#ave employees been provided
with appropriate 55E that is
well fitting and adequate?
,s it being used, when
appropriate?
,s it properly maintained 6
stored?
Health an" safety iss#e In"icate if satisfactory or
note "efects
(ction $y
!hom &
!hen
)omplete"
*ate/initials
+?' Fire Safety
Has a Fire @isk (ssessment
$een carrie" o#t-
,s 2ire equipment adequate and
properly maintained?
,s there an evacuation
procedure 6 are fire notices
provided?
Are fire drills conducted
regularly? (date of last 7 drills?)
++' /achinery & E6#ipment
,s all machinery properly
guarded?
#ave portable electrical
appliances been regularly
inspected 6 labelled?
+0' Aehicles on site
Are vehicles and pedestrians
clearly separated on site?
,f not, have the ris&s been
assessed and controls put in
place to prevent accidents?
+2' Off site 1isits
Are off site visits planned and
arranged in accordance with
5lymouth 3ity 3ouncils8 -utdoor
Education code?
Are ris& assessments reviewed
after each trip?
+4' *oc#mentation an" >roce"#res
#as )chool #6) 3ode ( 5olicy
been issued to all staff ?
(has it been reviewed in the last
+7 months?)
,s there a system for accident
(wor& related ill health( near miss
reporting (to #6) 0eam)?
Are incidents investigated by
#ead 0eacher ( #6) Advisers?
#ave 9is& Assessments been
completed and a 9egister
maintained ?
Are there written safe systems of
wor& for high ris& activities?
