COMPANY’S NAME

Company’s Logo
SAFETY AUDIT CHECKLIST ‘DOCUMENT REGISTER NUMBER’

Name of Auditor : Position title :

Company/workplace : Date :

ELECTRICAL CHECKLIST

No Description Yes No N/A Remarks

Electrical switchboards and equipment
1 Are switchboards and electrical equipment in a safe
condition?
2 Is everything on the switchboard clearly labelled?
3 Have safety switches (residual current devices) been
fitted to all circuits?
Power points, light fittings and switches
1 Are all power points, light fittings and switches in a safe
place and free from obvious defects (eg: loose covers or
wires, broken or damaged fittings, signs of
overheating)?
2 Are isolating switches clearly labelled and accessible?
Power tools, flexible leads and power boards
1 Is portable electrical equipment protected by safety
switches?
2 Are all power tools, extension leads and power boards
maintained in a safe operating condition (check for
damaged insulation, water leaks, burn marks, bent or
loose pins or fittings)?
3 Are extension leads and power boards located in a safe
position to prevent mechanical or other damage
(including trips)?
Inspecting and maintaining electrical equipment
1 Are all electrical fittings and electrical equipment,
including portable power tools, regularly inspected and
maintained?
2 Have all the power leads been inspected and tagged?

Audited by: Signature: Date:

Reviewed by: Signature: Date:

Name of Auditor : Position title :

 COMPANY’S NAME
Company’s Logo
SAFETY AUDIT CHECKLIST ‘DOCUMENT REGISTER NUMBER’

them?
First aid and emergency procedures
Company/workplace : Date :
1 Do you have first aid facilities to deal with splashes or
other chemical emergencies (eg deluge showers, eye
washes)?
2 Do you have equipment to deal with accidental release
of chemicals (eg containment barriers, absorption
material)?
Personal protective equipment (PPE)
1 Do you provide adequate PPE (eg gloves, eye
protection) as required?
2 Do you and your workers maintain PPE in accordance
with the manufacturers’ instructions?

Audited by: Signature: Date:

Reviewed by: Signature: Date:

Name of Auditor : Position title :

Company/workplace : Date :

MACHINERY AND EQUIPMENT CHECKLIST

No Description Yes No N/A Remarks

Safety devices
1 Are machine guards in place on all operating
equipment?
2 Are belts, pulleys and other rotating parts properly
guarded?
3 Are emergency stop buttons clearly marked and
operational?
Work areas
1 Is there sufficient clearance space around all plant?
2 Are machinery and equipment areas kept clean and free
from obstructions?
3 Is the ventilation adequate?
4 Are steps taken to reduce machinery noise (eg isolating
the plant, mufflers and baffles)?
 COMPANY’S NAME
Company’s Logo
SAFETY AUDIT CHECKLIST ‘DOCUMENT REGISTER NUMBER’

5 Are tools and portable equipment stored safely?

Safe operation
1 Are workers trained to operate machinery safely?
2 Do they hold any necessary certificates of competency
(eg forklift)?
3 Is your higher hazardous plant registered (eg boilers,
vehicles hoists)?
4 Are workers supervised to ensure correct procedures are
followed?
5 Is machinery and equipment regularly inspected for
damage or wear?
6 Is machinery and equipment maintained according to
the manufacturers’ instructions?
Personal protective equipment (PPE)
1 Do you provide adequate PPE (eg safety footwear, eye
protection, hearing protection) as required?
2 Do you and your workers maintain PPE in accordance
with the manufacturers’ instructions?
Audited by: Signature: Date:

Reviewed by: Signature: Date:

Name of Auditor : Position title :

Company/workplace : Date :

MANUAL HANDLING CHECKLIST

No Description Yes No N/A Remarks

Work tasks
1 Can all materials be lifted and carried easily?
2 Are mechanical aids (such as trolleys and hoists)
available and used?
3 Are workers trained in manual handling techniques and
the use of mechanical aids?
Work equipment
1 Are work benches a comfortable height?
2 Are chair backs and seat heights adjustable?
3 Is office equipment (such as computer keyboards and
screens) adjusted to avoid body strain?
4 Are storage shelves organised to minimise bending and
stretching
 COMPANY’S NAME
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SAFETY AUDIT CHECKLIST ‘DOCUMENT REGISTER NUMBER’

Work organisation
1 Are tasks rotated to avoid repetitive work?
2 Is work planned to balance out periods of high and low
demand?
3 Are workers able to take adequate breaks?
Work area
1 Do workers have adequate space to enable ease of
movement?
2 Are items that are regularly-used within easy reach?
3 Is there sufficient area around machines or equipment to
enable access for maintenance and repair?

Audited by: Signature: Date:

Reviewed by: Signature: Date:

Name of Auditor : Position title :

Company/workplace : Date :

FORKLIFT TRUCK CHECKLIST

No Description Yes No N/A Remarks

Traffic management plan
1 Do you have a system in place to ensure pedestrian and
forklift traffic are kept separated?
2 Can you re-design the workplace layout to reduce or
remove the need for pedestrians to be in areas where
forklifts operate?
3 Are pedestrian walkways clearly marked and even
controlled by gates?
4 Are exclusion zones for pedestrians clearly signed?
Certificates
1 Does the operator/s have a current certificate of
competency?
2 Are forklifts fitted with safety devices or structures
 COMPANY’S NAME
Company’s Logo
SAFETY AUDIT CHECKLIST ‘DOCUMENT REGISTER NUMBER’

adequate for the tasks being performed?

Daily Inspection
1 Overhead Guard
Broken Welds?
Missing bolts
Damaged Areas
2 Hydraulic Cylinders
Leakage?
Damaged on lift, tilt or attachment cylinder
3 Mast Assembly
Broken welds
Cracked or bent areas
4 Lift Chains and Rollers
Wear or damaged, kinks or rust
Is lubrication required
Squeaking sound

5 Tyres
Cut around tire
Rubber pieces missing
Missing lugs
Bond separation

6 Battery Check
Cells caps and terminal covers in place
Cable insulation missing
Fully charged
Battery secure properly
Cable connection secured

7 Hydraulic Fluid
Any sign of leakage at hoses

8 Gauges
Are they working properly

9 Steering
Is there excessive free play
 COMPANY’S NAME
Company’s Logo
SAFETY AUDIT CHECKLIST ‘DOCUMENT REGISTER NUMBER’

Is power steering pump working

10 Brakes
Pedal goes to floor
Work in reverse
Parking brake work

11 Light and horn

Work properly
Horn loud enough to be heard over environment noise

12 Safety seat belts

Functioning and working

13 Fire extinguisher unit

Available and in good condition

Audited by: Signature: Date:

Reviewed by: Signature: Date:

Name of Auditor : Position title :

Company/workplace : Date :

SLIPS, TRIPS AND FALLS CHECKLIST

No Description Yes No N/A Remarks

Floors
1 Are floors free of water, ice, oil or other fluids?
2 Are floor surfaces even (eg no loose tiles or carpet that
is torn or has ridges or holes)?
3 Are ramps designed to prevent slips and falls?

Housekeeping
1 Are walkways and doorways clear of boxes, extension
cords and litter?
2 Are spills cleaned up immediately?
Are the responsibilities for cleaning floors, clearing
work areas and walkways clearly specified?
 COMPANY’S NAME
Company’s Logo
SAFETY AUDIT CHECKLIST ‘DOCUMENT REGISTER NUMBER’

Stairs
1 Are stairways kept clear of boxes, extension cords and
litter?
2 Is the tread on stairs adequate to minimise slipping?
3 Is the tread on each stair adequate?
4 Are hand-rails adequate?

Lighting
1 Are work areas, walkways and stairs well lit?
2 Does the lighting enable workers to move between
indoor and outdoor tasks safely?

Footwear
1 Is the footwear worn by workers suitable for the
workplace?

Audited by: Signature: Date:

Reviewed by: Signature: Date: