Office, Classroom and General Area Inspection Form

Building _____________________ Room ________________________________ 

Supervisor of Area ____________________ Date___________________________

Inspection Performed by: _____________________

  Y N NA COMMENTS

Walking Surfaces
Aisles established and clear        
Tripping hazards are eliminated (i.e., placement of electrical cords,
equipment, boxes)		        
Floors even (no holes or cracks)        
Carpets and rugs secure        
Floors kept dry - not slippery        
Entrance mats available (wet weather)        
Outside walkways and stairs in good repair        

Bookcases, Shelves, Cabinets
Wall shelves designed for intended load (heavy duty hardware
and brackets for heavy loads, i.e., for book storage)		        
Shelves not overloaded        
Heavy storage cabinets, bookcases and file cabinets secured to the wall to prevent tipping        
File drawers closed when not in use (only one open at a time to prevent tipping)        
Cartons, supplies, etc. stacked carefully so that they won't fall        

Electrical Hazards
All extension cords are 3-wire type (3-prong) and the cord in
good condition- no splices or broken insulation (no cracks or fraying)		        
Only one extension cord used - not plugged into other extension cords        
Equipment power cords in good condition - no splices or
broken insulation		        
Plugs in good condition - no exposed wires
(where plug is joined at the cord)		        
Wall outlet and junction box covers in place
(prevents accidental exposure)		        
Circuit breaker panels clear
(nothing blocking access, at least 30" open area)
and labeled to indicate area served		        
The use of multi-plug electrical outlet adapters to obtain
more outlets is not permitted		        
Circuits not overloaded - all multiple outlet strips
equipped with overload protection		        
Multiple outlet strip is not plugged into another multiple outlet strip.
And only one multiple outlet strip is plugged into a dual electrical outlet.		        
Wires or extension cords are prohibited from being
placed under carpets or rugs, through doorways,
or placed in other traffic areas (fire hazard) 		       
Ground Fault Circuit Interrupters (GFCI's)
installed where required		        
Electrical tools and equipment grounded
or of the double insulated type (UL listed)		        

Stairways, Ramps, Corridors, Storage Areas
Adequate lighting in place (including emergency lighting)        
Ramps have non-slip surface        
Stair treads in good condition        
Stairway clear - not used for storage
(including under the stairway)		        
Handrails installed - in good condition
(i.e., sturdy, no rough edges)		        
Guardrails installed (where needed)        

Corridors kept clear of equipment and supplies
(areas with an occupancy of >50 people, 44" required)
(areas with an occupancy of < 50 people, 36" required)

        
Storage within 18 inches of sprinkler heads prohibited
(24" from the ceiling where no sprinkler system exists)		        
Ladders provided for high storage areas
(Never use top step or rung)		        

Office Equipment
Chairs in good condition and adjustable
(when appropriate)		        
Paper cutter equipped with guard
- blade spring functioning		        
Step stools available for use, where needed        

Fire Prevention, Emergency Exits, Housekeeping
Fire equipment is accessible (not blocked or obstructed)
[i.e., extinguishers, pullstations, fire hoses]		        
Fire extinguishers have current inspection tags
(monthly inspection by Facilities should be done)		        
Fire extinguisher wall-mounted in readily accessible location.        
Fire hose inspection tags current        
Fire doors are kept closed (not blocked open)        
All doors close and latch properly        
Exits to buildings are accessible (not obstructed and not locked, making emergency exit possible)        
Exits properly marked, exit signs illuminated        
Directions to exits marked with visible signs, when not immediately apparent (In corridors)        
Are doors or stairways that are neither exits nor access to exits appropriately marked, "Not an Exit", "To Basement", etc.        
Good housekeeping practiced - excess paper, computer cartons, and trash removed        
Office has current "In Case of Emergency" sign posted in area (i.e., near phone, exit, or pullstation)        
Are electric space heaters being used and given adequate space ( at least 3 ft.)        
Emergency evacuation routes posted in hallways        
Combustible materials are kept out of boiler, mechanical, or electrical equipment rooms        

Classrooms, Places of Assembly
Desks are in good condition (No broken legs and tops, splintering, sharp edges)        
Chairs are in good condition (No broken legs and seats, splintering, sharp edges)        

Miscellaneous
Smoking is prohibited in unauthorized areas        
Exposed steampipes insulated from accidental contact        
Ceiling tiles are in good condition (not water damaged or missing)        
Inspection stickers in elevators are up to date        
Pictograph sign posted over elevator call station, on all floors,
showing "In case of fire, do not use elevators, use stairways"		        
For Special Areas:        
Chemical Use in Non-laboratory Areas        
Material Safety Data Sheets are readily available        
Eyewashes are available in close proximity and unobstructed
(where corrosive chemicals or chemicals that are
harmful to eyes are used)		        
Eye protection available and used where needed
(safety glasses or goggles for flying particles,
chemical splash goggles for chemical splash)		        
Open-toed shoes prohibited in areas where corrosives are used        
Refrigerators used for chemical storage labeled "No Food"        
Chemical containers clearly labeled with chemical name(s)
(preferably manufacturer's label)		        
Waste containers clearly labeled with the chemical name(s)
and the words "waste" or "hazardous waste" (stockroom tag attached)		        
Chemicals and waste containers are not stored near drains
(if so, the container is stored in a tub)		        
Large/heavy containers and corrosives stored on lower shelves        
Flammable liquids used in well-ventilated area and not used
or stored near ignition sources (i.e., flames, sparks)		        
Fluorescent bulb storage in loading dock area neat and orderly
- drums and boxes labeled as "Universal Waste"		        
Ballasts and batteries stored in leak-proof containers and
labeled as "Non-regulated waste"		        
Compressed gas cylinders are chained, strapped or
secured properly (to prevent tipping)		        
Compressed gas cylinders are labeled and stored with
protective valve caps in place, when not
connected to a regulator		        
Compressed gas cylinders are stored away from heat sources        
When not in use, oxygen and fuel gas (acetylene) cylinders are
stored separately (20 ft. apart or separated by 5'
high non-combustible wall) 		       

Additional Comments or Recommendations:
 

 

 

 

Please make any corrections that have been noted.  Indicate "corrected" and sign the form.  Return the form to the inspector, named at the top, within one month.

Department Head/Supervisor ___________________________

Signature

University of the Sciences in Philadelphia • 600 South Forty-third Street • Philadelphia, PA 19104-4495 • phone: 215-596-8800 • email: safety@usip.edu