BASIC LIFE SAFETY

Finding (circle one)

1.

Is the Fire Emergency Plan posted?

Yes

No

NA

2.

Are corridors and exits free from obstructions?

Yes

No

NA

3.

Are exit signs illuminated and visible?

Yes

No

NA

4.

Are stairwell doors held open by means other than electromagnetic devices?

Yes

No

NA

5.

Are emergency instructions and telephone numbers at telephone?

Yes

No

NA

HAZARDOUS MATERIALS

6.

Are eye protection devices available?

Yes

No

NA

7.

Are gas cylinders secured against falling?

Yes

No

NA

8.

Are chemicals properly labeled and stored?

Yes

No

NA

EMPLOYEE TRAINING

9.

Have Powered Industrial Truck Operators been trained?

Yes

No

NA

10.

Have employees been trained in proper lifting techniques?

Yes

No

NA

11.

Have employees been trained on operating equipment?

Yes

No

NA

12.

Have employees received Hazard Communication Training?

Yes

No

NA

13.

Have employees received personal protective equipment training?

Yes

No

NA

FIRE PREVENTION

 14.

Is storage permitted within 18-inches of spinkler heads?

Yes

No

NA

 15.

Is smoking prohibited in storerooms and storage areas?

Yes

No

NA

 16.

Is housekeeping in order?

Yes

No

NA

ELECTRICAL SAFETY

17.

Are electrical cords worn and frayed?

Yes

No

NA

18.

Are extension cords used in place of permanent wiring?

Yes

No

NA

19.

Are a sufficient number of outlets available?

Yes

No

NA

 20.

Do power cords have grounding plugs intact?

 Yes

No

NA