Health and Safety Checklist Form Template
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Health and Safety Checklist Form

Please fill out the form with your information below.

Company Name

    Address

      Date of Inspection

        Inspector Name

          Section I. Workplace Hazard Assessment

          Are potential hazards identified?

          Are hazard signs displayed properly?

          Is emergency lighting operational?

          Are first aid kits stocked and accessible?

          Are PPE requirements posted?

          Section 2: Environmental Health and Safety

          Are floors clean and dry?

          Is waste disposed of in a timely manner?

          Are restrooms clean and well-stocked?

          Additional Observations and Recommendations

            Date:

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