1. Is documentation of safety training, workplace self-inspections, and hazard corrections maintained and accessible to regulatory agencies?
Yes (Satisfactory)
No (Needs Correction)
N / A
Corrective Action: Confirm location and existence of safety records.
Date Corrected:
2. Have employees in the area been trained on the applicable Disaster Plan?
Yes (Satisfactory)
No (Needs Correction)
N / A
Corrective Action: Contact EH&S for a copy of the Disaster Plan.
Date Corrected:
3. Are fire alarm pull boxes clearly identifiable and unobstructed?
Yes (Satisfactory)
No (Needs Correction) N / A
Corrective Action: Clear area of obstructions.
Date Corrected:
4. Are fire hose stations and/or portable extinguishers clearly identifiable and unobstructed?
Yes (Satisfactory)
No (Needs Correction)
N / A
Corrective Action: Label fire-fighting equipment and clear area of obstructions.
Date Corrected:
5. Are fire extinguishers tagged with inspections at least annually?
Yes (Satisfactory)
No (Needs Correction) N / A
Corrective Action: Contact the Facilities Department to arrange for a fire extinguisher inspection. Ensure that the extinguisher is properly tagged after the inspection.
Date Corrected:
6. Do self-closing devices and door latches on fire-rated doors (doors that open into corridors or stairwells) work properly? (Doorstops are not permitted.)
Yes (Satisfactory)
No (Needs Correction)
N / A
Corrective Action: Contact the Facilities Department to arrange for door repairs.
Date Corrected:
7. Are there at least 18 inches (47 cm) of vertical clearance maintained between all stored items and any ceiling equipped with fire sprinklers?
Yes (Satisfactory)
No (Needs Correction)
N / A
Date Corrected:
Corrective Action: Remove stored items that do not meet the above criteria.
8. Are electrical panels accessible and circuit breakers clearly identified?
Yes (Satisfactory)
No (Needs Correction)
N / A
Corrective Action: Label circuit breakers as to their function, and clear area in front of electrical panels by 36 inches.
Date Corrected:
9. Are aisles, exits, and adjoining hallways maintained free of obstructions so that the area can be easily evacuated or accessed in case of an emergency?
Yes (Satisfactory)
No (Needs Correction)
N / A
Corrective Action: Remove obstructions from aisles, exits, and adjoining hallways. Contact the Facilities Department if help is needed cleaning adjoining hallways.
Date Corrected:
10. Has all electrical equipment that is required to be grounded (e.g., copiers and computers) been grounded? (Ensure that the grounding pin has not been removed and that 3-pin to 2-pin adapters are not used.)
Yes (Satisfactory)
No (Needs Correction)
N / A
Corrective Action: Contact the Facilities Department to arrange for installation of appropriate outlets and plugs.
Date Corrected:
11. Are extension cords in good condition (e.g., no breaks or exposed wiring), used only as temporary wiring (less than 30 days), and not connected in series?
Yes (Satisfactory)
No (Needs Correction)
N / A
Corrective Action: Do not connect extension cords in series. Dispose of or repair all electrical cords that are not in good condition, and replace those in use more than 30 days with permanent wiring.
Date Corrected:
12. Has all broken, unguarded, or otherwise dangerous equipment and furniture been repaired or removed? (Example: A paper cutter without a guard to keep fingers away from the blade.)
Yes (Satisfactory)
No (Needs Correction)
N / A
Corrective Action: Contact the Facilities Department to arrange for removal or repair of equipment or furniture.
Date Corrected:
13. Do all powerstrips have circuit breakers? (Only powerstrips with a circuit breaker reset switch should be used. Extension cords are not allowed as permanent wiring.)
Yes (Satisfactory)
No (Needs Correction)
N / A
Corrective Action: Replace powerstrips without circuit breaker with ones that have them. Do not connect power strips and/or extension cords in series. Dispose of or repair all electrical cords that are not in good condition, and install permanent wiring to replace those that have been used for more than 30 days.
Date Corrected:
14. Are floor surfaces free of slip or trip hazards?
Yes (Satisfactory)
No (Needs Correction)
N / A
Corrective Action: Work with your supervisor, the Safety Coordinator, or Safety Committee to address this issue.
Date Corrected:
15. Is furniture and equipment over five feet tall braced to prevent tipping in an earthquake?
Yes (Satisfactory) No (Needs Correction
