5s Audit Check Sheet
5s Audit Check Sheet
5s Audit Check Sheet
DEPARTMENT:
DATE:
AUDITOR:
TIME:
0 = No Compliance 1 = Very Little Compliance 2 = Some
Compliance 3 = Significant Compliance 4 = Total Compliance
Comments/Action
Determine what is the needed and remove the rest.
0 1 2 3 4
to be taken
SORT
Have all the unnecessary items (tools, machines, boxes, etc.) been
removed from the work place.
Does the inventory include any parts that are not required?
SORT
Comments/Action
A place for everything and everything in its place … No searching!
0 1 2 3 4 to be taken
SYSTEMATIZE
Comments/Action
Cleaning and looking for ways to keep it clean.
0 1 2 3 4 to be taken SHINE
Floors- Are they kept clean, tidy and in good state?
Machines and Tools- Are they free from dirt, visible leaks and
spillage?
SHINE
Bins- Are they properly maintained and emptied on a regular basis?
Is anyone responsible for routine inspection/maintenance in your
department?
Is your working place clean, tidy and in good working environment
all the time?
Comments/Action STANDARDIZ
Make standards obvious a and maintained
0 1 2 3 4 to be taken E
ease?
Is information to carry out daily work routine clear and in use?
Are improvement ideas being generated and regularly acted on?
Are the standards for the first 3S's clear and up to date?
Comments/Actio SUSTAI
Maintain high standards and consistently seek to improve
0 1 2 3 4 n to be taken N
Are checklist available and being used?
SUSTAIN
Q25: KNOWLEDGE - Ask 4 employees of the 5 Benefits of 5S (-1 point for each person
that
cannot explain)
DIFFERENCE (+/-) - Compare this month’s score to previous month to see if
improvements DIFFERENCE
are being made.
SCORE
(+/-)
Prepared by: Ma. Kristina N. Pozon - Nurse Supervisor
Criteria Adopted from Ganeshmrgn/ A Technical Knowledge (Reference:
https://ganeshmrgn.wordpress.com/)