Instructions:
Use this worksheet to inspect your facility
for compliance. If the question does not apply
to your situation, mark "N/A". A "No"
answer indicates that corrective action is required
to remedy the situation.
GENERAL
WORK ENVIRONMENT
Yes/No
Is
the worksite clean, and orderly?
Are
work surfaces kept dry or are appropriate steps
taken to assure the surfaces are slip-resistant?
Are
spilled materials cleaned up immediately?
Are
covered waste cans used for oily and paint soaked
waste?
WALKWAYS
Yes/No
Are
holes in the floor, sidewalk or other walking
surface repaired or covered?
Are
floor openings, such as pits, guarded by a cover,
a guardrail, or equivalent on all sides (except
at entrance to stairways or ladders)?
Are
materials or equipment stored in such a way that
sharp objects will not protrude in to or interfere
with the walkway?
Are
walkways with guardrails provided over conveyors
and similar hazards?
Are
aisles of sufficient width to permit free movement
of employees bring and removing material?
STAIRS
AND STAIRWAYS AND ELEVATED SURFACES
Yes/No
Are
handrails at a height between 30 and 34 inches
on all stairways?
Are
all stairways at least 22 inches (55.88 centimeters)
wide?
Are
step risers on stairs evenly spaced from top to
bottom?
Are
steps on stairs and stairways kept in a condition
which will minimize the risk of slips and falls?
Are
stairway handrails secure?
Where
stairs or stairways exit directly into any area
where vehicles may be operated, are adequate barriers
and warnings provided to prevent employees stepping
into the path of traffic?
Are
surfaces, other than stairways, elevated more
than 4 feet above the floor or ground provided
with standard guardrails which have a toprail
at 42 inches, a midrail at 21 inches and a 4 inch
toeboard?
Is
there a stable method provided to employees to
reach elevated storage and work surfaces?
PORTABLE LADDERS
Yes/No
Are
all ladders maintained in good operable condition
as follows?
Joints
between steps and side rails are tight
All
hardware/fittings are securely attached and
moveable parts operating without binding/play
No
missing steps or broken cleats(footrests)
Rungs
uniformly spaced at 12 inches
If
any defects are detected, are ladders either taken
out of service and marked "OUT OF SERVICE"
or are the ladders destroyed and /or replaced?
Are
employees using ladders properly, e.g., not standing
on the top step of a stepladder, not using metal
ladders around electrical equipment?
When
portable ladders are used to gain access to elevated
platforms, roofs, etc., does the ladder always
extend at least 3 feet (0.9144 meters) above the
elevated surface?
Do
you see metal ladders being used where the ladder
or the person using the ladder could come in contact
with energized parts of equipment, fixtures or
circuit conductors?
