Blank Health and Safety Inpection

Health and Safety Inspection Report
HSP
Organisation:
Date:
Date of Last Inspection:
Date of Next Planned Inspection:
Inspection carried out by:
Risk Assessment
Have risk Assessments been completed
Are there any written risk assessments
Yes
yes
yes
No
Actions Comments
General House Keeping

Are work areas clean and tidy
Are storage areas clean and tidy
Are outside areas clean and tidy
Are walkways / passageways clear of obstruction
Are there any trip hazards from cables
Are staircases marked / handrails / nose treads
Yes
No
Action Comments
Lighting
Are all lights working
Is the lighting suitable
Is emergency lighting in place
Are there records of emergency lighting tests
Are light switches easily assessable
Yes
No
Actions Comments
First Aid
First aid box in place with correct contents
Are contents in date
Is there an eye wash station or bottle (in date)
Is there a designated first aider at all times
If there a back up appointed person
Is the accident book in place
Is the first aid station signposted
Is legal indemnity of first aiders in place
Yes
No
Actions Comments
Personal Protective Equipment

Is PPE available
Is the wearing of PPE enforced
Has it been signed for
Is an old for new policy is place
Yes
No
Actions Comments

HSP
Flooring
Are floor coverings in good condition free from trip
hazards
Is there an arrangement to clear any spillage
Are warning signs put in place during cleaning
Are tiled areas clean
Yes
No
Actions Comments
Racking and Shelving

Is it secure
Is there a need to stretch to reach shelving
Are heavier items stored at the lower levels
Is it overloaded
Is the safe working load displayed
Does it have any visual damage
Yes
No
Actions Comments
Portable Electrical Equipment

Is there an inventory of equipment
Do users carry out visual checks of equipment
Has it been tested
Is there a record of test
Does it pose a trip hazard
Yes
No
Actions Comments
Emergency Exits / Fire Precautions

Are exits free from obstruction and not locked
Are they clearly marked
Are there sufficient extinguishers
Are fire extinguishers serviced
Are they accessible
Have employees received training in evacuation
Has an evacuation been taken place in the last 12
months
Is there a nominated fire warden and deputy
Is the safe assembly point clearly marked
Are there records of fire alarm tests
Are smoke / heat alarms tested
Are break glass call points tested
Yes
No
Actions Comments
Display Screen Equipment

Has a risk assessment been carried out of work
stations
Are work stations suitable
Are cables managed to avoid slips and trips
Are Chairs in good condition
Have users been identified
Have DSE Users had eye tests
Do the computers have a firewall and virus protection
Yes
No
Actions Comments

HSP
Are all pass words confidential and deleted when not

required
Are regular breaks taken from the screen
Do employees use lap top computers
Are document holders, wrist rests and foot rests
provided
Lone Working
Is there ever any lone working
Are they contacted in contact by phone/ pager
Do lone workers report they are safe at the end of the
working session
Do lone workers carry a personal attack alarm
Yes
No
Action Comments
Environmental / Workplace safety

Are Heating systems maintained
Are Air Conditioning systems maintained
Is workplace temperature and humidity reasonable at
all times
Are water temperatures monitored
Are there any water tanks
Do you have a legionella management programme
Are Electrical and Lighting systems maintained
Is a wholesome supply of drinking water available
Are waste bins provided
Is waste removed daily
Are there any special waste containers (sharps etc)
Yes
No
Action Comments
Health and Safety Information

Is the health and Safety law poster displayed
Is the evacuation notice displayed
Is the organisation Safety Mission Statement
displayed
Is the employers Liability insurance certificate
displayed
Is copies of risk assessments available
Are COSHH Assessments available
Yes
No
Action comments
Control of Substances Hazardous to Health

Has a inventory of hazardous substances been
produced
Have assessments been made for their safe use
Have employees working with substances received
training
Has PPE been issued.
Is PPE kept clean, maintained and stored correctly
Are substances stored in a secure area
Are all containers clearly marked
Are waste substances disposed of correctly
Yes
No
Action Comments

HSP
Welfare Facilities
Are there separate male and female water closets
Are there a sufficient number of water closets
Is there a disabled facility
Are toilet areas well lit and ventilated
Are there washing facilities with soap and drying
facilities
Is there a shower facility
Are there facilities for the storage of personal
clothing
Is there a rest area
Yes
No
Action Comments
Welfare continue
Could the rest area be used by pregnant or nursing
woman
Are changing areas provided for example changing
into a uniform
Are non smokers protected from passive smoking
Is there a facility to sit and eat a meal
Is there a facility to heat a meal and make a hot and
cold drink
Yes
No
Action Comments
Training
Is induction training carried out
Is induction training recorded
Are Health and Safety training needs identified
Are records of health and safety training kept
Yes
No
Action Comments
Noise
Have you identified any noise issues
Have noise levels been assessed
Do you have any noise records
Are areas of high noise identified with appropriate
signage
Are employees issued with Hearing Protection
Have employees received training on the dangers of
noise and how to use hearing protection
Yes
No
Action Comments
Manual Handling
Are employees trained in manual handling lifting
technique
Are mechanical devices available
Are mechanical devices inspected, maintained
Yes
No
Action Comments
Company Vehicles
Are all drivers insured
Are vehicles displaying a valid road fund licence
Are they subject to a current MOT if applicable
Yes
No
Action Comments

HSP
Are maintenance records kept

Are mileage records kept
Do drivers hold a valid driving licence
Does the vehicle carry a first aid kit
Work equipment
Is work equipment inspected before use
Are maintenance records kept
Are start and stop controls checked daily
Are all guards in place and used
Is the work equipment suitable for the task
Yes
No
Action Comments
Miscellaneous
Is there any known asbestos in the building
Has an asbestos survey been undertaken
Do you have records of asbestos testing
Do you have an authorised and approved contractor
list
Do you have a list of contractors to call in an
emergency situation
Yes
No
Actions Comments
RECORDS OF AMENDMENTS
ISSUE
DATE
CHANGE
February 06
Review
ISSUE
February 06
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Health and Safety Inspection Report

General House Keeping

Personal Protective Equipment

Racking and Shelving

Portable Electrical Equipment

Emergency Exits / Fire Precautions

Display Screen Equipment

Are all pass words confidential and deleted when not

Environmental / Workplace safety

Health and Safety Information

Control of Substances Hazardous to Health

Are maintenance records kept

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