Record of 5S Date ____________ Assessor Name: ________________________

AREA 1 : Production Area

Patrol Score
No PIC Name Area Seiri Seiton Seiso Seiketsu Shitsuke Kaizen Muda Average Finding Note
(Set in (Standard- (Improve- (Eliminate
(Sort)
Order)
(Shine)
ize)
(Sustain)
ment) Waste) Score

PRODUCTION
Production 1st Floor Area
Production 2nd Floor Area
Material Preparation Area
Boiler Room & yard
Anis, Budi & Stair & Emergency Stair
1 Production Table Lifter
Team ABCG inside building area,
ABCG outside building area

FILLING
Rest Room
Filling Area.
Cooling Tower Area,
Endan & Waste Grease (outside area)
2
Filling Team Drum Empty (outside area)
1st Floor Mesh Cleaning

DECANTING
Employee Toilet,
Decanting Room,
David & Packaging Storage Area
3 Decanting Decanting WIP Area,
Team Waiting Inspection Area.
Non Conforming Product Area.

PPIC
Shipping Area,
Good Product Storage Area
Raw Material Storage Area
Base Oil Pump Facility
Satria & Base Oil Tank & Floor Area.
4 PPIC Team Base Oil Land (behind Tank).
Base Oil Loading Street
Forklift Parking Area

LABORATORY
Arifah (L) Laboratory Area
5 Sample Storage Place
Tatok
Score Criteria: 1 = No Implementation, 2 = Poor Implementation, 3 = Fair Implementation, 4 = Good Implementation, 5 = Excellent (World Class) (L = Leader).
Record of 5S Date ____________ Assessor Name: ________________________

AREA 2 : Administration & Public Area

Patrol Score
No PIC Name Area Seiri Seiton Seiso Seiketsu Shitsuke Kaizen Muda Average Finding Note
(Set in (Standard- (Improve- (Eliminate
(Sort)
Order)
(Shine)
ize)
(Sustain)
ment) Waste) Score

OFFICE ROOM
Frans (L)
1
Sendy Office Room
Medical Room

PUBLIC AREA
(INSIDE BUILDING )
Office Warehouse
Tini (L) Pantry , Canteen & Corridor.
2 Azis Locker Male & Female
Tito Toilet Male & Female
Production Toilet
Pray Room (Male & Female)

MEETING ROOM & LOBBY

Meeting Room.
Sri (L) Guest Room.
3 Sunarso Lobby & Terrace
Rener

PUBLIC AREA
(OUTSIDE BUILDING )
All Green Yard Area
Driver Room & Toilet
Security Room
Purwanto (L), Smoking Area
Sunarso, Waste Building & Yard
4
Ansor All Parking Area
Driver Waste Water Treatm. Facility
Factory Frontside Area
Workshop
Score Criteria: 1 = No Implementation, 2 = Poor Implementation, 3 = Fair Implementation, 4 = Good Implementation, 5 = Excellent (World Class) (L = Leader).
5 S Checklist - Workplace Evaluation o = OK, x = NG
Area
Category Check Item 1 2 3 4 5

Is there un-needed equipment, tools, furniture, etc. are present ?

Is there un-needed items are on walls, bulletin boards, etc ?

Seiri / Sort
(Distinguish between
Is there any improvement activity to minimize the waste of things or movement?
what is needed and
not needed)
Is there any un-necessary motion? Is there any no added value activity ?

Is there un-needed inventory, supplies, parts, or materials are present ?

Is there correct places for items are not obvious, or quantity limits are not obviuos ?
Seiton / Set in
Is there items are not in there correct places ?
Order
(A place for
Is there any aisleways, workstations, equipment locations are not indicated ?
everything and
everything in its
Is there any condition that generate waste of time or energy to take tools/things?
place)
Is there any improvement activity to minimize the waste of time or energy?

Is the Floors, walls, stairs, and surfaces not free of dust, dirt, oil and grease ?

Seiso / Shine Is there any equipment not kept clean and free of dust, dirt, oil, and grease ?
(Cleaning, and
looking for ways to Are the cleaning materials/tools not easily accessible ?
keep it clean and
organized) Are the Lines, labels, signs, etc. not clean and unbroken ?

Is there any improvement activity to minimize the generation of dirt and dust?

Is there any necessary of 5S information which is not available ?

Seiketsu /
Standardize Is there any standards/rule about 5S that is not known and visible by employee?
(Maintain and
monitor the first Is there any checklists and record for cleaning and maintenance 5S activity ?
three catagories)
Is there any activity to review the 5S rule/standard to improve the 5S implementation?

Is there any worker who is not familiar with 5S concept ?

Does the cleaning activity is well implemented & recorded ?

Shitsuke / Sustain
Is there any rule/standard/work ethics that is applied to maintain the disciplinary?
(Stick to the rules)
Does the employee wear uniform or clothes follow the rule ?

Does employee wear uniform/shoes/clothes in proper condition (clean, no damage) ?

Kaizen / Is every person involved to the follow up of 5S finding?

Improvement
(To maintain or Is there any follow up action of 5S finding without any progress?
achieve competitive
advantage through a
well managed, Is there any self improvement ? (improvement which is not come from patrol finding).
dynamic change
process) Is there any standardization to prevent the re-occurrence of 5S finding?

Is there any excess of inventory (raw material, finish good, WIP, stationary) ?
Muda / Eliminate
Waste
Is there any over-processing (inefficient process step)?
(Any process that
consumes more
Is there unnecessary transportation (movement of material or person to other place)?
resources than
needed, which
Is there any waiting process (stop process due to waiting next process completion) ?
causes waste to
consumes more
resources than
needed, which
causes waste to
occur)
Is there any inefficient of resources consume such of electricity, water, paper, etc ?