Canadian Deafblind Association

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1 Canadian Deafblind Association L Association Canadienne de la Surdicécité Ontario Chapter WORKPLACE INSPECTION CHECKLIST Program Name Date Completed Inspector(s) Name(s) EXTERNAL ENVIRONMENT Are walkways clear of articles? B Moderate C Minor) Are walkways clear of ice/snow/wet leaves? Are there tripping hazards? Are handrails secured? Is there adequate lighting front & back doors? Is the lighting motion activated? Are entrances and exits obscured?

2 INTERIOR COMMON AREAS Is the entrance hall obstructed with: - Boots/shoes/clothing? - Boxes/equipment/garbage? Are handrails secured? Are stairs in good repair? Are halls and stairways well lit? Are bed bug checks being performed? KITCHEN AREA Is there broken or loose flooring? Are small appliances safely away from sinks? Are appliances in good repair? Is the outlet a breaker switch near the sink? Is there a step-stool for hard-to-reach items? Is there baking soda close to the stove? Is there a stove vent?

3 Is there a fire extinguisher? BATHROOM AREA Is the supply of soap/toilet paper/hand towels adequate? Is there a non-slip surface or mat in the tub? Is there a non-slip mat on the floor? Is the outlet a breaker switch? Are there are signs of mold or mildew? BASEMENT Is the lighting adequate for duties performed there? Is the floor congested? Is the floor area damp or slippery? Is there a step-stool for hard-to-reach items? Are the exits clear from obstacles? Do you know where the electrical panel is located? Are there are signs of mold or mildew?

4 LAUNDRY ROOM/AREA Is the electrical panel accessible and free of dust and debris? Is the dryer lint catcher being cleaned regularly? Is the dryer vent tube connected and clear of debris? FIRE SAFETY Are there working smoke detectors? Is there one smoke detector per floor? Were the batteries in the smoke detector(s) changed when the clocks last changed? How many floors are in the house? Is there a carbon monoxide detector in the house? How many fire extinguishers are in the house? When were the fire extinguishers last inspected? Are occupants and staff familiar with the household fire evacuation plan? MATERIAL HANDLING Did you observe any unsafe material handling (poor body mechanics, applying of high force)?

5 Did you observe any unsafe lifting or transferring? Are there are lifting devices in place? If YES, when was the last annual inspection? Are lifting device maintenance records available? VEHICLE INSPECTIONS Is there an emergency kit in the vehicle? If YES, is it fully stocked? Are vehicles inspections being completed at all times? Are inspection forms being filled out properly? Are vehicles undergoing regular maintenance? WHMIS Are Material Safety Data Sheets (MSDS) available and accessible to staff? Are the MSDS less than three (3) years old? Are all containers clearly labelled to meet WHMIS standards? GENERAL Are power bars and proper extension cords used extensively? Are emergency telephone numbers posted in a clear location near a telephone?

6 Is there a copy of the Act (OHSA) posted? If YES, where is it posted? Are the names of all JHSC members posted? Is there an emergency/72 hour kit? If YES, have expiry dates been checked on all food items? When the first aid kit was last checked? Are employees aware of the location of the first aid kit? Is the Health & Safety Policy Statement posted? If YES, has it been signed within the last year? Is the Workplace Violence & Harassment Policy posted? If YES, where is it posted? Are mobility aids and Snoezelen equipment being cleaned? 2 staff questions or discussion items please record. E.G. (Where are policies posted, who do you inform if you have had an incident, who is your JHSC representative) Staff Member Interviewed onsite (name) Actions/Recommendations Inspector(s) Signature(s) Inspector(s) Signature(s) Supervisor s Signature Health and Safety Officer Signature

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