Example Workplace Health & Safety Inspection Form (General/Offices)
Note only items with the potential to affect health and safety should be recorded
on this form, non-safety maintenance items should be recorded separately.
DATE............................................. LOCATION /
AREA .......................................................
ASSESSORS ..........................................................................................................
..............
Health and safety issue
1. Housekeeping
Are workplaces tidy, well
maintained and materials
safety stored? Consider
Storage of materials
(avoid storage in gangways and
fire evacuation routes; heavy
items and liquids should not be
stored above shoulder height)
Condition of traffic routes
and entrances / exits
Are pedestrian routes clear?
Avoid tripping or slip hazards
(such as trailing cables, frayed
carpets, loose tiles, spilt
liquids)?
Maintenance and condition of
the building structure
E.g. condition of walls,
windows, steps, stairs,
handrails; is shelving fixed in
place?
Indicate if satisfactory or
note defects
Action by
whom &
when
Completed
Date/initials
Health and safety issue
Indicate if satisfactory or
note defects
Action by
whom &
when
2. Environmental Conditions
Are conditions satisfactory?
Lighting
Heating
Ventilation
Noise
3. Manual Handling
Identify any hazardous
manual handling activities.
Have risks been assessed?
Y/N
Have regular handlers been
trained in safe lifting?
Y/N
How can risks be reduced
further?
4. Design & Use of Display Screen Equipment (DSE) Workstations
Are staff workstations
ergonomically designed?
Consider.
Layout of workstations,
adequate space, suitability of
furniture?
Seating / posture of DSE
users(refer to Appendix 1)
Is screen image clear
Are lighting levels OK? Any
glare (blinds provided)?
Have eye tests been offered to
DSE users, are sufficient rest
breaks taken?
Have DSE workstations been
assessed?
YES / NO
Date of last assessment:
Completed
Date/initials
Health and safety issue
Indicate if satisfactory or
note defects
5. Welfare Facilities
Are welfare facilities suitable
and sufficient?
Kitchens / canteen / rest areas
Toilets
Washing / changing facilities
6. First Aid Facilities
Are numbers of Trained First
Aiders adequate?
Are there sufficient First Aid
Kits?
Are they well stocked and their
location known? (who
inspects?)
7. Safety Signs
Are safety and fire signs
adequate and in good
condition?
Can signage be improved?
8. Work with Hazardous Substances (where applicable)
Have COSHH Assessments
been produced and updated?
Y /N
Are controls implemented?
Storage
Handling / use
Dust or fume extraction
tested?
9. Personal Protective Equipment PPE (where applicable)
Have employees been provided
with appropriate PPE that is
well fitting and adequate?
Is it being used, when
appropriate?
Is it properly maintained &
stored?
Action by
whom &
when
Completed
Date/initials
Health and safety issue
Indicate if satisfactory or
note defects
10. Fire Safety
Has a Fire Risk Assessment
been carried out?
Is Fire equipment adequate and
properly maintained?
Is there an evacuation
procedure & are fire notices
provided?
Are fire drills conducted
regularly? (date of last 2 drills?)
11. Machinery & Equipment
Is all machinery properly
guarded?
Have portable electrical
appliances been regularly
inspected & labelled?
12. Vehicles on site
Are vehicles and pedestrians
clearly separated on site?
If not, have the risks been
assessed and controls put in
place to prevent accidents?
13. Off site visits
Are off site visits planned and
arranged in accordance with
Plymouth City Councils Outdoor
Education code?
Are risk assessments reviewed
after each trip?
14. Documentation and Procedures
Has School H&S Code / Policy
been issued to all staff ?
(has it been reviewed in the last
12 months?)
Is there a system for accident
/work related ill health/ near miss
reporting (to H&S Team)?
Are incidents investigated by
Head Teacher / H&S Advisers?
Have Risk Assessments been
completed and a Register
maintained ?
Are there written safe systems of
work for high risk activities?
Action by
whom &
when
Completed
Date/initials