Manufacturing Safety Assessment

1.1 Assessor Name

First NameLast Name

1.2 Assessor Email

example@example.com

1.3 Date

Date

1.4 Business Unit Name

1.5 Business Unit Facility

1.6 Who is the HSE Manager

First NameLast Name

1.7 Man Hours Last 365

1.8 Number of Recordable Injuries 365

1.9 Number of LTIs 365

1.10 TRIR

1.11 LTIR

1.12 EMR

1.13 OSHA Citation(s) Last 3 Years

1.14 Other Regulatory Citation(s) Last 3 Years

1.15 Upload Citations

1.17. Overall Assessment Summary

Risk Ranking Format: Each finding is assigned a risk designation using the format Consequence-Severity-Probability-Risk Rank. Consequence is identified by letter (P = People, E = Environment, A = Asset, R = Reputation), followed by the numerical Severity rating, Probability rating, and resulting Risk Rank from the IWS Risk Severity Ranking Matrix. For example, P-3-5-4 represents a People consequence, Severity 3 (Lost Time Injury), Probability 5 (Frequent Occurrence), resulting in an overall Risk Rank of 4.

2.1 General Site Safety Conditions

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Overall housekeeping and cleanliness.
2. Work areas organized and maintained.
3. Building condition and general maintenance.
4. Walking-working surfaces free of hazards.
5. Materials properly stored and staged.
6. Tools properly stored and maintained.
7. General site security and access controls.
8. Facility lighting adequate.
9. Overall employee safety awareness.
10. Management demonstrates active safety oversight.
11. Hazards promptly identified and corrected.
12. Safety expectations clearly communicated.
13. Safety culture promotes safe work practices.
14. Overall facility presents a safe and orderly work environment.

2.2 Safety Management System

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Are safety best work procedures available to workers?
2. Does management take an active role in supporting safety initiatives?
3. Are injuries immediately reported and investigated for cause and corrective actions to prevent recurrence?
4. Is a Stop Work or Good Catch program in place to encourage workers to stop and evaluate a hazardous condition or behavior?
5. Are Stop Work or Good Catches rewarded to encourage participation?
6. Are OSHA 300 logs completed and posted as required by CFR?

2.3 Safety Assessments

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Are safety assessments conducted on a regular schedule?
2. Are at-risk findings assessed for risk rank and potential for occurrence?
3. Are at-risk findings corrected and closed out?

2.4 Sanitation

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Restrooms clean and stocked.
2. Drinking water is accessible and safe.
3. Hand wash facilities present.
4. Food storage adequate.

2.5 Permitting

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Are permits required for hazardous work that could potentially injure or kill employees such as confined spaces, welding and cutting, electrical work, ground disturbances, etc.?

2.6 Walkways and Floors

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Ensure clear, unobstructed walkways.
2. Check for slip, trip, and fall hazards (e.g., spills, uneven surfaces).
3. Verify proper signage for wet or hazardous areas.

2.7 Lighting and Ventilation

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Adequate lighting for all work areas, including emergency exits.
2. Proper ventilation, especially in areas with dust, fumes, or chemicals.

2.8 Struck-by Hazards

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Inspect areas where moving machinery, vehicles, or tools could strike workers.
2. Verify proper use and visibility of machine guards and shields.
3. Ensure tools and materials are secured and stored safely to prevent falling or being ejected.
4. Evaluate traffic control measures and pedestrian pathways in forklift and vehicle operation zones.
5. Are workers aware of and protected from struck-by hazards involving machinery or vehicles?
6. Are equipment and material-handling practices compliant with safety protocols?

2.9 Caught-in/Between

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Examine machinery and equipment for pinch points and entrapment risks.
2. Verify proper guarding of moving parts on presses, conveyors, and other equipment.
3. Check that workers are following proper lockout/tagout procedures.
4. Assess work areas for hazards such as collapsing structures, unsecured loads, or improperly stored materials.
5. Are machines equipped with functioning guards to prevent caught-in hazards?
6. Are employees trained to avoid working in areas with entrapment risks?

2.10 Safety Equipment and Conditions

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Fire extinguishers present, charged, and inspected.
2. Emergency exits clearly marked.
3. Exits not obstructed.
4. Electrical panels clear and free from obstruction.
5. Lighting adequate.
6. Noise levels less than 80 dB over an 8-hour TWA.
7. Safety signs present and prominently displayed.
8. Housekeeping- Work areas free of clutter, spills, and hazards.

2.11 Emergency Response

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Emergency Action Plan available to workers.
2. Emergency Action Plan complete with emergency phone numbers, directions, and facility coordinates.
3. First aid kits available and stocked with current supplies.
4. Fire alarms and sprinklers charged, in working order, and inspected annually?
5. Emergency body/eye shower provided for corrosive chemicals?

2.12 Items of Deficiency

2.13 Photo/File Upload

3.1 Machine Guarding

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Check that guards and shields are installed and functioning on machinery.
2. Inspect for signs of wear, damage, or missing safety features.
3. Controls and switches properly labeled and functioning.
4. Emergency stop mechanisms accessible and functional.

3.2 Lockout/Tagout (LOTO) Procedures

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Verify LOTO procedures are in place and followed during maintenance.
2. Inspect locks, tags, and procedures for compliance.

3.3 Equipment Maintenance

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Ensure all machinery is on a regular maintenance schedule.
2. Look for signs of improper use or damage.

3.4 Tools

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Check for proper safety features on hand tools like power saws, grinders, drills, and other tools including functioning emergency stop mechanisms.

3.5 Ergonomics

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Assess workstations for proper height and layout.
2. Identify risks of repetitive motion injuries.

3.6 Items of Deficiency

3.7. Photo/File

4.1 Hazard Communication

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Ensure Safety Data Sheets (SDS) are available for all chemicals.
2. Proper labeling of chemical containers.

4.2 Storage

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Flammable and hazardous materials stored properly (e.g., flammable cabinets).
2. Verify proper segregation of incompatible materials.

4.3 Handling and Disposal

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Proper procedures for handling chemicals.
2. Check for the correct disposal of waste materials.
3. Spill kits and containment measures in place.
4. Ventilation adequate for hazardous material use.

4.4 Labeling

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Hazardous materials properly labeled and stored.
2. Check for the correct disposal of waste materials.

4.5 Items of Deficiency

4.6. Photo/File

5.1 PPE Availability

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Ensure the availability of PPE, such as gloves, goggles, helmets, ear protection, and steel-toed boots.

5.2 PPE Compliance

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Verify employees are trained and consistently using appropriate PPE.
2. PPE regularly inspected and replaced if damaged.

5.3 Respiratory Protection

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Assess the need for respiratory equipment and ensure compliance with fit-testing and maintenance.

5.4 Fall Protection

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Inspect elevated work areas (e.g., mezzanines, scaffolds, ladders) for proper fall protection systems.
2. Verify the presence and condition of guardrails, safety nets, and personal fall arrest systems (PFAS).
3. Ensure ladders are in good condition, appropriately rated, and used correctly.
4. Check for floor openings, unprotected edges, or uneven surfaces that pose fall risks.
5. Are fall protection systems installed and properly maintained?
6. Are employees trained in fall protection equipment use?
7. Harnesses and lanyards available and in good condition.

5.5 Items of Deficiency

5.6. Photo/File

6.1 Electrical Equipment

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Electrical panels: Accessible and labeled.
2. Inspect for damaged cords, outlets, or panels.
3. Verify proper grounding and circuit labeling.
4. Check for the presence and accessibility of Lockout/Tagout (LOTO) systems during equipment maintenance.
5. Ensure all electrical work is performed by qualified personnel.
6. Are electrical hazards identified and mitigated through safe work practices?
7. Are employees trained in electrical safety procedures?
8. Overload protection: Circuit breakers and fuses in working condition.

6.2 Fire Hazards

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Identify and mitigate potential ignition sources near flammables.
2. Confirm proper storage and handling of welding equipment and gas cylinders.

6.3 Items of Deficiency

6.4. Photo/File

7.1 Hot Work Safety

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Assess compliance with hot work permit systems outside of designated hot work areas.
2. Regular inspections of areas deemed as designated hot work areas.

7.2 Welding Equipment

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Inspect welding machines, cables, and connections for damage.
2. Confirm proper ventilation to prevent accumulation of fumes.

7.3 Grinding Operations

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Verify tool condition and the use of proper guards.
2. Ensure workers wear eye and face protection.

7.4 Items of Deficiency

7.5. Photo/File

8.1 Cranes, Hoists, and Forklifts

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Check for proper inspections and maintenance records.
2. Assess operator training and certification.
3. Lifting equipment properly maintained and inspected.

8.2 Manual Lifting

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Verify ergonomic lifting techniques and aids.
2. Provide training to reduce strain injuries.

8.3 Storage Racks

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Ensure racks are stable and free of overloading or damage.

8.4 Items of Deficiency

8.5 Photo/File

9.1 Noise Levels

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Measure sound levels to ensure compliance with OSHA standards.
2. Provide hearing protection where necessary.

9.2 Dust and Particulate Control

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Check for the effectiveness of dust collection systems.
2. Assess the use of respiratory PPE in dusty environments.

9.3 Chemical and Fume Exposure

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Monitor for proper ventilation and air quality.

9.4 Items of Deficiency

9.5 Photo/File

10.1 Training Records

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Confirm all employees have received proper safety training.
2. Assess competency for hazardous operations.

10.2 Safety Policies

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Review safety procedures and policies for thoroughness and relevance.
2. Ensure they are up-to-date and accessible.

10.3 Inspection and Audit Records

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Verify routine safety inspections are conducted and documented.

10.4 Items of Deficiency

10.5 Photo/File

11.1 Safety Meetings

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Ensure regular safety meetings are held to address risks and feedback.

11.2 Incident Reporting

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Confirm a clear and accessible system for reporting accidents and near misses.

11.3 Employee Feedback

Rows	Acceptable	Unacceptable	Corrected	N/A
1. Solicit worker input on safety concerns and suggestions for improvements.

11.4 Items of Deficiency

11.5 Photo/File

Notes:

File Upload

Manufacturing Safety Assessment

1. General Information

Risk Rank Matrix

2. General Facility and Site Safety

3. Machinery, Equipment, and Tools

4. Chemical and Material Handling

5. Personal Protective Equipment (PPE)

6. Electrical and Fire Safety

7. Welding, Cutting, and Grinding

8. Lifting and Material Handling

9. Environmental and Health

10. Documentation and Training

11. Worker Engagement

12. Additional Feedback