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Sample Safety Inspection Checklist
Form used by Louisiana Office of Risk Management as part of the state's safety program.
Handle: Document-3693
Owner: Laiche, Karen (User-23, klaich:DocuShare)DS
Wednesday, June 17, 2009 03:13:29 PM CDT
Wednesday, June 17, 2009 03:13:29 PM CDT
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  • SAMPLE SAFETY INSPECTION CHECKLIST NAME OF AGENCY/OFFICE: _____________________________________________________________ Area(s) Inspected: _____________________________Inspected by: _______________________Date:____________ ITEM YES NO CORRECTIVE ACTION – DATE 1. Is there litter or spilled liquid on the floor?
  • 44. Are features of fire protection, such as sprinklers, fire alarms and hoses, kept clean and in good working order?
  • MISCELLANEOUS: 51. Are Safety Inspections conducted in accordance with the time frame specified in the agency’s loss prevention manual?
  • 52. Are Safety Meetings conducted in accordance with the time frame specified in the agency’s loss prevention manual?
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Microsoft Office Word (.doc, .dot) - application/msword
ORM Sample Safety Inspection Checklist.doc
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Appears In: SAFETY FORMS
Preferred Version: Sample Safety Inspection Checklist