Form – Joint Occupation Hazard and Safety Committee (JOHSC)

Name of Individual Conducting the Inspection*

First Last

Email*

Site Inspected*

GENERAL - MULTIPLE LOCATIONS

The floors are clear of debris, loose materials, worn carpet, etc.*

If corrective action is necessary, indicate person responsible and timeline.

The floors are not slippery or wet and there are no spills.*

If corrective action is necessary, indicate person responsible and timeline.

The furniture is safe (no sharp edges, designed for the purpose).*

If corrective action is necessary, indicate person responsible and timeline.

The furniture is safe (no sharp edges, designed for the purpose).*

If corrective action is necessary, indicate person responsible and timeline.

The area is not crowded.*

If corrective action is necessary, indicate person responsible and timeline.

Materials are neatly and safely stored.*

If corrective action is necessary, indicate person responsible and timeline.

Storage shelves are loaded only to capacity.*

If corrective action is necessary, indicate person responsible and timeline.

Large and heavy objects are stored on waist high shelves.*

If corrective action is necessary, indicate person responsible and timeline.

File cabinet drawers are not overloaded.*

If corrective action is necessary, indicate person responsible and timeline.

File cabinet have the heaviest items stored in bottom drawers.*

If corrective action is necessary, indicate person responsible and timeline.

Step stools are available to reach higher shelves.*

If corrective action is necessary, indicate person responsible and timeline.

Items are not placed or stored to create a trip hazard.*

HAZARDOUS SUBSTANCES

Hazardous substances are properly labelled.*

If corrective action is necessary, indicate person responsible and timeline.

A material safety data sheet is available for each product?*

If corrective action is necessary, indicate person responsible and timeline.

Workers are trained in how to use these products safely.*

If corrective action is necessary, indicate person responsible and timeline.

Required PPE is available.*

If corrective action is necessary, indicate person responsible and timeline.

KITCHEN

The food preparation area is clean.*

If corrective action is necessary, indicate person responsible and timeline.

The furniture is safe and in good working order.*

If corrective action is necessary, indicate person responsible and timeline.

Appliances in use are in good working order.*

If corrective action is necessary, indicate person responsible and timeline.

HALLS

Are they clear and unblocked?*

If corrective action is necessary, indicate person responsible and timeline.

RECEPTION AREA

The furniture is safe (no sharp edges, designed for the purpose).*

If corrective action is necessary, indicate person responsible and timeline.

Computer workstations are set-up appropriately.*

If corrective action is necessary, indicate person responsible and timeline.

Extension cords do not pose a tripping hazard.*

If corrective action is necessary, indicate person responsible and timeline.

Wall and ceiling fixtures are fastened securely.*

If corrective action is necessary, indicate person responsible and timeline.

Paper and waste are properly disposed of.*

If corrective action is necessary, indicate person responsible and timeline.

Desk and file drawers are kept closed when not in use.*

If corrective action is necessary, indicate person responsible and timeline.

EMERGENCY EQUIPMENT

Fire extinguishers are regularly tested and certified.*

If corrective action is necessary, indicate person responsible and timeline.

Emergency lighting in place and regularly tested.*

If corrective action is necessary, indicate person responsible and timeline.

There is a clear path to reach fire equipment.*

If corrective action is necessary, indicate person responsible and timeline.

First aid kits are available and stocked.*

If corrective action is necessary, indicate person responsible and timeline.

HEALTH AND SAFETY POSTINGS

The Health & Safety policy is current and posted.*

If corrective action is necessary, indicate person responsible and timeline.

JOHSC names and contact information are current and posted.*

If corrective action is necessary, indicate person responsible and timeline.

The OHS Act is posted.*

If corrective action is necessary, indicate person responsible and timeline.

LIGHTING

There are no bare lightbulbs.*

If corrective action is necessary, indicate person responsible and timeline.

Lightbulbs are working and there are no dark areas.*

If corrective action is necessary, indicate person responsible and timeline.

BATHROOM

Washroom areas are clean.*

If corrective action is necessary, indicate person responsible and timeline.

Washroom fixtures are in good working order.*

If corrective action is necessary, indicate person responsible and timeline.

Hygiene supplies are available (soap, paper towel)*

If corrective action is necessary, indicate person responsible and timeline.

I certify that the information contained in this JOHSC report is accurate.

Signature