HOUSEKEEPING CHECKLIST
Workplace Inspected By:                                                              Inspection Date:

Inspection Item                                      Yes   No   N/A   Action Required                   By Who          By When   Completed
                                                                                                                                  Yes/No/Date
Floors
Clean and uncluttered

Free of slip, trip and fall hazards

Aisleways unobstructed

In good repair

Stairways
Clear, with effective emergency lighting

Handrails in good order

Exits
Clearly marked

Locking devices work

Doors open outwards

Is there more than one exit?
 Date                             COMPANY NAME                                                          Reference No
 Sept 07                          Housekeeping Checklist                                                20.4

 Page                             Authorised by                        Version 1.0                      Revision Date
 Page 1 of 6                                                                                            Sept 09
Page 1 of 6

                                       HOUSEKEEPING CHECKLIST
                                                                                Page 2 of 6




Date          COMPANY NAME                                      Reference No
Sept 07       Housekeeping Checklist                            20.4

Page          Authorised by                    Version 1.0      Revision Date
Page 2 of 6                                                     Sept 09
HOUSEKEEPING CHECKLIST
                                                                                                                         Page 3 of 6
Workplace Inspected By:                                                            Inspection Date:

Inspection Item                                    Yes   No   N/A   Action Required                   By Who          By When     Completed
                                                                                                                                  Yes/No/Date
Waste Disposal
Materials
Rubbish checked
Shelving bins in place, used and cleared
regularly
Signs/labels legible and in place
Clear instructions posted for toxic waste
disposal
Properly stored and/or stacked

Personal Protective Equipment
Stools/ladders In good order

Walkways identifiedin good order:
Worn correctly and

Racking
Safety footwear

Hats, hair restriction
Stable and in good repair

Hearing forklift operation
Clear forprotection

Safety Aid
First glasses/goggles/face shields
Gloves kit in place and identified
First Aid

Respirators aider identified
Qualified first

Overalls/dust coats
First aid kit well stocked
 Date                           COMPANY NAME                                                          Reference No
 Sept 07                        Housekeeping Checklist                                                20.4

 Page                           Authorised by                        Version 1.0                      Revision Date
 Page 3 of 6                                                                                          Sept 09
HOUSEKEEPING CHECKLIST
                                                                                                                             Page 4 of 6
Workplace Inspected By:                                                               Inspection Date:

Inspection Item                                       Yes   No   N/A   Action Required                   By Who          By When      Completed
                                                                                                                                      Yes/No/Date
Electrics
Panels identified and accessible

Plugs, connectors and leads in good order

Lockout tags in use

Cords, plugs and equipment are maintained
and tested regularly

Fire Protection
Portable extinguishers appropriate

People are trained to use equipment

Manual call points identified, unobstructed and
in good condition

Fire warden identified

Equipment is regularly checked

Fire procedure notices in place

Date                              COMPANY NAME                                                           Reference No
Sept 07                           Housekeeping Checklist                                                 20.4

Page                              Authorised by                         Version 1.0                      Revision Date
Page 4 of 6                                                                                              Sept 09
HOUSEKEEPING CHECKLIST
                                                                                                                       Page 5 of 6
Workplace Inspected By:                                                            Inspection Date:

Inspection Item                                    Yes   No   N/A   Action Required                   By Who          By When        Completed
                                                                                                                                     Yes/No/Date
Extraction
Dust/fume units operational

Vents clean and unobstructed

Dust/fume units sufficient

Adequate ventilation

Dangerous Goods
Clearly identified

Labels clear and sufficient

Safety signs (eg No Smoking, PPE) displayed

Fire equipment nearby

Material Safety Data Sheets readily available

Appropriately stored



Date                           COMPANY NAME                                                           Reference No
Sept 07                        Housekeeping Checklist                                                 20.4

Page                           Authorised by                         Version 1.0                      Revision Date
Page 5 of 6                                                                                           Sept 09
HOUSEKEEPING CHECKLIST
                                                                                                                               Page 6 of 6
Workplace Inspected By:                                                           Inspection Date:

Inspection Item                                   Yes   No   N/A   Action Required                   By Who          By When      Completed
                                                                                                                                  Yes/No/Date
Vehicles
Forklifts in good order

Operator trained

Maintenance checks undertaken

Licences up to date

Compressed Gases
Shut off valves marked and accessible

Gauges in good order

Cylinders stored upright and secured

Valves and lines labelled

Stored away from heat sources

GENERAL COMMENTS:


Date                          COMPANY NAME                                                           Reference No
Sept 07                       Housekeeping Checklist                                                 20.4

Page                          Authorised by                         Version 1.0                      Revision Date
Page 6 of 6                                                                                          Sept 09

20.4 housekeeping checklist

  • 1.
    HOUSEKEEPING CHECKLIST Workplace InspectedBy: Inspection Date: Inspection Item Yes No N/A Action Required By Who By When Completed Yes/No/Date Floors Clean and uncluttered Free of slip, trip and fall hazards Aisleways unobstructed In good repair Stairways Clear, with effective emergency lighting Handrails in good order Exits Clearly marked Locking devices work Doors open outwards Is there more than one exit? Date COMPANY NAME Reference No Sept 07 Housekeeping Checklist 20.4 Page Authorised by Version 1.0 Revision Date Page 1 of 6 Sept 09
  • 2.
    Page 1 of6 HOUSEKEEPING CHECKLIST Page 2 of 6 Date COMPANY NAME Reference No Sept 07 Housekeeping Checklist 20.4 Page Authorised by Version 1.0 Revision Date Page 2 of 6 Sept 09
  • 3.
    HOUSEKEEPING CHECKLIST Page 3 of 6 Workplace Inspected By: Inspection Date: Inspection Item Yes No N/A Action Required By Who By When Completed Yes/No/Date Waste Disposal Materials Rubbish checked Shelving bins in place, used and cleared regularly Signs/labels legible and in place Clear instructions posted for toxic waste disposal Properly stored and/or stacked Personal Protective Equipment Stools/ladders In good order Walkways identifiedin good order: Worn correctly and Racking Safety footwear Hats, hair restriction Stable and in good repair Hearing forklift operation Clear forprotection Safety Aid First glasses/goggles/face shields Gloves kit in place and identified First Aid Respirators aider identified Qualified first Overalls/dust coats First aid kit well stocked Date COMPANY NAME Reference No Sept 07 Housekeeping Checklist 20.4 Page Authorised by Version 1.0 Revision Date Page 3 of 6 Sept 09
  • 4.
    HOUSEKEEPING CHECKLIST Page 4 of 6 Workplace Inspected By: Inspection Date: Inspection Item Yes No N/A Action Required By Who By When Completed Yes/No/Date Electrics Panels identified and accessible Plugs, connectors and leads in good order Lockout tags in use Cords, plugs and equipment are maintained and tested regularly Fire Protection Portable extinguishers appropriate People are trained to use equipment Manual call points identified, unobstructed and in good condition Fire warden identified Equipment is regularly checked Fire procedure notices in place Date COMPANY NAME Reference No Sept 07 Housekeeping Checklist 20.4 Page Authorised by Version 1.0 Revision Date Page 4 of 6 Sept 09
  • 5.
    HOUSEKEEPING CHECKLIST Page 5 of 6 Workplace Inspected By: Inspection Date: Inspection Item Yes No N/A Action Required By Who By When Completed Yes/No/Date Extraction Dust/fume units operational Vents clean and unobstructed Dust/fume units sufficient Adequate ventilation Dangerous Goods Clearly identified Labels clear and sufficient Safety signs (eg No Smoking, PPE) displayed Fire equipment nearby Material Safety Data Sheets readily available Appropriately stored Date COMPANY NAME Reference No Sept 07 Housekeeping Checklist 20.4 Page Authorised by Version 1.0 Revision Date Page 5 of 6 Sept 09
  • 6.
    HOUSEKEEPING CHECKLIST Page 6 of 6 Workplace Inspected By: Inspection Date: Inspection Item Yes No N/A Action Required By Who By When Completed Yes/No/Date Vehicles Forklifts in good order Operator trained Maintenance checks undertaken Licences up to date Compressed Gases Shut off valves marked and accessible Gauges in good order Cylinders stored upright and secured Valves and lines labelled Stored away from heat sources GENERAL COMMENTS: Date COMPANY NAME Reference No Sept 07 Housekeeping Checklist 20.4 Page Authorised by Version 1.0 Revision Date Page 6 of 6 Sept 09