GEMBA Walk

GEMBA Walk

GEMBA Walk/Safety Observation Program form.

MM slash DD slash YYYY
Building/Area
Observer Name
Time
:
PassFail
1. Are all crew members observed working safely?
2. Is PPE and safety equipment in good condition and being used as required (sleeves, cut gloves, proper knives, etc)?
3. Are signs in place in areas where PPE is required?
4. Are emergency eyewash stations/showers clearly marked, in working order, clean, nozzle caps in place, not obstructed, and have been inspected at least weekly?
5. Are hoses and cords coiled or reeled, and are air hoses equipped with nozzles to reduce air flow to below 30 psi?
6. Is machine clean, work station and aisle ways free of clutter and debris, and free of slip/trip hazards?
7. All necessary safety signs visible and in good condition (nip points/pinch points, etc)?
8. Adequate walkways throughout workstations and conveyor system?
9. Broken mirrors or plastic guards?
10. Is the machine or area 7S ready, every place for a thing, everything in it’s place?
11. Are free of oil/water leaks, drips, spills, and are catch pales for water/glue clean and labelled?
12. Are ladders stored properly in the proper labeled location?
13. Are machine centers, trash cans, cabinets/drawers free of food/drink/first aid related items?
14. Are all exit lights illuminated?
15. Are all emergency exit aisles/pathways, and door ways clear and accessible?
16. Are spill kits available, clean, and identified with signage?
17. Pallet jacks labeled and stored in a safe location?
18. Are trash cans & scrap bins labeled and empty, or at a reasonable level?
19. Is the top of the machine or power cabinet free of containers, rags, tooling, etc?
PassFail
20. Are safe lifting, pushing, and pulling practices being uses?
21. Are knife policies being followed (especially on wetend of Corrugator)?
22. Are guards on the machine and closed?
23. Are employee LOTO locks displayed, and is the procedure being conducted properly?
24. Do employees have clear, labeled, spill proof water bottles?
25. Are skids staged in the proper locations and at the maximum of 10 high?
26. Are employees aware of Safety Data Sheets (SDS) locations?
27. Are all containers sealed properly and labeled properly with GHS (globially harmonized system) labels (ink, glue, vaseline, etc)?
28. Are there no more than two cans of any one chemical at the machine, and are all chemicals stored in a flammables cabinet?
29. Are all machine guards in place on equipment while in operation?
30. Are safety interlocks operational and free of bypassing devices?
31. Any tape or wood being used as a temporary fix on the equipment?
32. Are lift truck warning devices and/or horns operational, are safety rules being followed, and are lifts inspected before each shift?
33. Are lift drivers completing their PIT EHS-118d inspection, and is their book with them on the lift they are using?
34. Fall protection is being used during work performed 4ft or greater above ground or work floor levels without permanent guarding?
35. Hoists/slings/straps in place and in good condition?
36. Bridge cranes/monorails/hoist lifting devices labeled with weight capacity?
37. Are employees keeping their hands safe while performing the tasks required of them?
PassFail
38. Do electrical panels exist, and are they closed and locked with ARC Flash sticker displayed?
39. Are covers on electrical panels, and are they labeled with proper voltage reading, and what they go to?
40. All electrical boxes and control panels on equipment have buttons or switches, and do they have functioning light bulbs?
41. All hoses/cords/wires/conduit in good condition?
42. Is there 3ft, or 36″ of clearance around electrical panels, I beams, and fire extinguishers?
43. Are all fire extinguishers up to date on inspection, charged, and accompanied by identification signage?
44. Area free of extension cords in lieu of permanent wiring?
45.