Go digital today! Convert your paper checklists into digital forms Scan this QR code to use this paper checklist on your smartphone or tablet or visi https://safetycuture.com/ oo] SafetyCulture Title Page Client / Site Date and Time of Inspection Inspected by Location General Information Number of Employees Description of work to be performed Take a photo of the work areaErgonomic Are all workers trained on safe working postures? Yes No N/A Are all workers trained on safe lifting techniques, uses, and carrying devices? Yes No N/A REFERENCE: This is a sample training on safe lifting techniques. [This is an example of how you can use iAuditor to include best practice reference images in your templates to assist with inspections] Are all workers knowledgeable about ergonomics policies and procedures? Yes No NIA Do workers feel free to report ergonomic symptoms? Yes No NIA rotation or rest breaks used to reduce time in awkward postures? Yes No NIA Does work scheduling minimize excessive overtime that causes fatigue? Yes No NIA there enough wor! kers to do individual workloads? Yes No NIAAre all workers instructed to get someone's help when lifting heavy materials? Yes No NIA Can the work be perfo med without twisting or overly bending the lower back? Clyes LIno LINA Are all employees protected against eyestrain or glare in the process of doing their job? Yes No N/A Are neck and sI houlders relaxed when performing tasks? Yes No NIA Are workers comfortable without experiencing any pressure points on any part of their body (wrists, forearms, back of thighs)? Yes No N/A Are all pieces of furniture or equipment adjusted, positioned, and arranged to minimize strain on all parts of the body? Yes No N/A ‘Are workstations set up properly? Yes No N/A Surfaces for Walking and Working Are working and walki ing surfaces clean and dry? Yes No NIAAre working surfaces unobstructed? Yes No N/A Are walking surfaces even? Fives [no LIN Materials Handling 10 materials have handles to help carry loads? Yes No N/A Are there carts, dollies, or other aids readily available for moving materials? Yes No N/A Is the site clear enough to permit the use of carts? Yes No N/A Are all materials delivered as close as possible to where they will be used? Yes No N/A Are all materials stored at waist height? Yes No N/A Are all loads labeled with their weight? Yes No N/ATools and Eq uipment Are all tools sharp and in good condition? Yes No N/A Are all tools light weight and well balanced? Yes No N/A Is there minimal vibration when using tools and equipment? Yes No N/A Do all tools have right handle design? Yes No N/A overhead? Are there scaffolds, platforms, or other equipment available to reduce the need to work Yes No NIA Are knee pads or cushions available when working at floor level? Yes No NIA Is there any equipment that can be used to reduce kneeling? Yes No NIA Is there anti i-fatigue matting to be used when a worker is required to stand all day? Yes No NIAIs it possible to use adjustable stools to allow workers to rest? Yes No NIA Seating Are the seats well-designed, easy to adjust, and comfortable? Yes No NIA Do workers have to lean forward to see/do their work when working on heavy quipment? 2 Yes No NIA Is the vibration minimal on the seating of any heavy equipment? Yes No NIA Completion Recommendations Overall Assessment Pass Fail Full Name and Signature of the Inspector The templates avalabe incur Public Library have been created by our customers and employees to help get you started using SafeyCulture’s Solutions. The remplates are intended tobe used as hypothetical examples only and should not be used asa substitute fr professional advice. ‘You should seck your awn professional ace to determine if the use ofa template is permissible your workplace or uiscton, You should Independently determine whether the templates stable for your creumstances.