Free Health and Safety Inspection Form Template
Health and Safety Inspection Form
Please fill out this form completely to ensure compliance with health and safety standards in the workplace.
Name
Date of Inspection
Workplace Address
Department Name
Inspection Purpose
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Routine Audit
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Incident Follow-Up
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Compliance
Is the environment clean and free of hazards?
Is proper lighting and ventilation provided?
Are fire extinguishers, alarms, and emergency kits available and functional?
Are first aid supplies adequately stocked and accessible?
Are employees following health and safety protocols?
Are personal protective equipment (PPE) used when required?
Are restrooms and break areas clean and operational?
Are evacuation plans and emergency procedures clearly displayed?
Have safety drills been conducted recently?
Immediate Actions Required
Overall Health and Safety Compliance
Supporting Documents
Attach any relevant PDF, image, etc.
Recommendations or Actions Required:
Provide any recommendations or actions required based on the inspection findings.
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[Your Name] Inspector [Date Signed] |
Requestor |
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