Workplace Safety Survey

Page 1 of 1     1. Department*         2. General*       Yes   No   N/A Are noise levels within acceptable limits?       Are temperature levels within acceptable limits?       Are work areas properly lit?       Are exits properly marked?       Are necessary areas accessable to people with disabilities?       Are basic first aid supplies available?       Is there a system in place to report safety violations?             3. Electrical safety*       Yes   No   N/A Are outlets and equipment properly grounded?       Are power cords in good condition?       Are extension cords used only as temporary wiring?       Do power strips include surge protectors?             4. Fire Safety*       Yes   No   N/A Are fire extinguishers properly located?       Are fire extinguishers up to date with inspections?       Are fire exits properly marked?       Are fire exits unobstructed?       Are smoke detectors properly functioning?       Is there a fire evacuation plan in place?             5. Hazardous Materials*       Yes   No   N/A Are hazardous materials kept away from food?       Are hazardous materials properly labeled?       Are hazardous materials properly stored?       Are hazardous materials properly disposed of?       Are hazardous materials handlers given adequate training       Is proper safety gear available for working with hazardous materials?       Is proper safety gear worn when handling hazardous materials?             6. Sanitation*       Yes   No   N/A Are dining areas kept clean?       Are restrooms kept clean?       Are soap and towels available for employees to wash hands?       Is the workplace free of rodents and insect pests?             7. Tools and Equipment*       Yes   No   N/A Are hand tools put away when not in use?       Are machine operators given adequate training?       Is proper safety gear available for working with machinery?       Is proper safety gear worn when working with machinery?       Are safety guards for moving parts kept in place?       Are machines used only when they are in complete working order?             8. Overall, how safe do you feel your workplace is?   Very Safe   Safe   Borderline   Unsafe   Very Unsafe       9. Please report any safety violations that you feel are being ignored or improperly resolved.