Area Board Templates

Ballarat Potato Plant

 Area Board Location Area Board Owner

Safety Cross 5S Audit

Hazard /
Near Miss Success
Reporting Story

Incident
5S Action
Reporting
Log

MDI General
Newspaper Maintenance
 Safety Cross
Area:

1 2

Month: 3 4
5 6
7 8
9 10 11 12 13 14 15 16
17 18 19 20 21 22 23 24
25 26
27 28 Green = Safe injury / incident free day

29 30 Yellow = First aid treatment / Incident

Red = Medical treatment or reportable

31 Injury
Safety Cross
 Hazard/Near Miss Register
Suggested Action Agreed Short Agreed Long Who When Date
Date Name Hazard/Near Miss
To Reduce Risk Term Action Term Action By By Completed

Hazard / Near
Miss Register
Incident Register
 General Maintenance Required
FILLED BY ORIGINATOR FILLED AT MDI WALK

Date Originator Problem Possible Solution Notification # Who When Result

General
Maintenance Required
 WORKPLACE 5S AUDIT
Auditor/s:
Select one box only on each line

Date: AREA: ______________________ Add total of all columns

Weighted Scoring
1 0
Please circle
either P or F

Category ITEM Pass Fail Action Required

If in doubt move it out!!
Is the area free of unnecessary tools / equipment / supplies / WIP. No items are on the floor or
P F
leaning on walls, chairs or work stations.

Sort All personal related items are removed from common areas. P F

Only current and relevant paperwork is stored in the work area P F

Emergency and safety equipment (where required) is in the zone, checked and operational. P F
A place for everything!
Walkways and forklift traffic areas are clearly identified and marked with proper warning signs. P F
All equipment is labelled and shadowed if required, and the operating parts (i.e. push buttons,
P F
switches, gauges) are clearly labelled and identified.
Straighten
Flammable substances and chemicals (if applicable) are stored in correct locations. P F

Hoses all rolled up and Put in place P F

Emergency and safety equipment is clearly marked, unobstructed and at point of use. P F
See it….Clean it!!!
There is not excessive overflow of product on the floor and under the vessels. P F
Shine
All performance and information boards are neat, tidy and up to date. P F

The workstation - floors, cabinets, desks, benches - are tidy and free of unnecessay items. P F
What's the standard?
Standard work, work instructions, SOPs are clearly posted if required, and only most recent version
Standardize is present.
P F

Emergency procedures posted (where applicable) P F

Create a Culture!
Sustain
Accountability for 5S in the area is visible. Who, When Etc. P F

Area sign off: ..................................................................... TOTAL

5S Audit
 Ballarat Potato Plant
Success Story
Area: (Zone) Originator: (Name)
Action Team: (Names of those involved in actioning)
BEFORE AFTER

(Insert comment here)

Success Story
5S Action Log
MDI Newspaper