5S Evaluation Form Date of evaluation

Evaluated by

Each line entry is worth a possible 10 points, total score is worth a possible 100 points.
Total Score _______
ZONE 1 Service Team Areas
RIP area - flow racks and skids neat & organized Dock area neat and organized - no old parts on dock
RIP area - floors, aisles, under flow racks clean Trash dumpster area clean & free of trash
RIP area - no parts or boxes sitting in aisles NCM area clean & organized
RIP location signs neat & in good condition Service Team's PC & KanBan area neat & organized
Hardware metros are neat & well organized Shipping aisles are clean, clear of equipment & skids

See attached comment sheet if box is checked

Total Score _______

ZONE 2 Rec. Office, Shipping Office, Inspection Area, Prod. Room, First Aid, Janitor Closet, Restrooms
Janitors Closet organized, clean, and neat Receiving Office area clean, organized, free of clutter
First Aid room is clean, organized, well stocked Inspection Office area clean, organized, free of clutter
Production Room is clean & clutter-free Shipping Office clean, organized, free of clutter
Men's restroom clean & well-stocked D.B. Roberts area neat and organized
Women's restroom clean & well-stocked Bulletin board (finished goods area) neat & up-to-date

See attached comment sheet if box is checked

Total Score _______

ZONE 3 Office Area, Conf. Rooms, Breakroom, Training Room, Library, & Storage Closets
Cubicles organized and neat in appearance Engineering conference table area clean & organized
Conf. Rooms organized & neat in appearance Main & Administrative Supply Closets clean & neat
All posted information & phone lists are up-to-date BreakRoom clean, free of clutter & trash
Computer Center is neat, free of trash and clutter Training Room organized, clean, free of clutter
Copier/Fax Area is neat, free of trash and clutter Library is neat & well organized

See attached comment sheet if box is checked

Total Score _______

ZONE 4 Maintenance Area, Building, & Grounds, and Entrances
Maintenance area is clean and neat Landscaping appears neat & well maintained
Tools/test equipment stored in organized manner Gazebo & picnic area well maintained, free of trash
Inside of building structure looks well maintained Trash dumpster area outside is clean, free of trash
Outside trash cans emptied Outside shipping & receiving docks clean, free of trash
Signs, lights, flag, mailbox, etc... well maintained Main & Employee entrances neat & clean

See attached comment sheet if box is checked

Uncontrolled Document