Safety Gemba Walk Checklist Template | Editable & Free Download

Safety Gemba walk checklist

About the Safety Gemba walk checklist

Imagine walking through your facility with confidence, knowing you have a reliable system for spotting risks before they become incidents. The safety Gemba walk checklist template helps guides you through focused on-site inspections that highlight unsafe practices, overlooked hazards, and improvement opportunities. It empowers teams to document findings in real time and track recurring issues. You’ll also be able to follow through on corrective actions with clarity and consistency.

Why you should use a safety Gemba walk checklist

The objective of the safety Gemba walk checklist is to provide a systematic way to observe and document safety practices in the workplace. By using this template, your team can identify safety hazards, ensure compliance with safety regulations, and implement corrective actions.

The benefits include enhanced safety awareness, thorough documentation of safety issues, and actionable insights that drive continuous safety improvements. This template stands out by offering a comprehensive framework that ensures no safety detail is overlooked, making it easier to maintain a safe working environment.

Key elements of the safety Gemba walk checklist

The safety Gemba walk checklist includes several key elements designed to capture comprehensive data during your safety walks.

PPE & safe work practices: This section checks the correct use and condition of personal protective equipment (PPE) and adherence to safe work practices.
Lifting devices: Ensures that material lifting devices are in good condition and used correctly, preventing accidents and injuries.
Emergency exits: Verifies that aisles and emergency exits are not blocked, ensuring quick and safe evacuation in case of an emergency.
Electrical safety: Checks for proper labeling, condition of electrical equipment, and compliance with safety standards to prevent electrical hazards.
Mobile equipment: Ensures that inspections are completed on mobile equipment and that operators are trained and licensed.
Material storage: Verifies that materials are stored safely and organized to prevent accidents.

Upgrade your workplace safety today

Download Lumiform’s safety Gemba walk checklist to proactively identify hazards, assess current safety measures, and implement improvements for a secure environment. Beyond compliance, this is about creating a culture of safety and efficiency. Take the first step towards a safer, smarter workplace now.

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Preview of the template

Audit

PPE & Safe Work Practices

Correct PPE worn and is it in good condition?

Metatarsal safety shoes worn and are they in good condition

Hearing protection worn

Gloves (if required)

Other required PPE?

Lifting Devices

Material lifting devices used and are they in good condition

Can operator explain daily inspection performed on lifting devices

Inspect lifting devices for worn or damaged devices

Are suspended loads attended

Suspended loads must never be lifted over employees

Safety Shower / Eye Wash Station

Is their a shower of eye station located where acids / bases (corrosives) used. " Sodium Aluminate"

Are they inspected monthly and access not blocked

Are eye wash stations available in high dust areas

Emergency Exits

Aisles and emergency exits not blocked

Electrical

Is voltage indicated on electrical control enclosures, power cabinets,, junction boxes etc.

Arc Flash label present on electrical control enclosures, power cabinets, junction boxes etc.

Clearance in front of electrical enclosures 36" (0-150v) and 42" (151-600v)

Chords are free from frays and damage

Extension cords only allowed for temporary situations

GFCI's required on portable electric tools and in areas where wetness or damage to cord is possible

Are knockout plugs present on all electrical enclosures

Mobile Equipment

Are inspections being completed on equipment, prior to being used before each shift

Mobile equipment license and training current within 3 years

Seatbelt used whenever forklift operated

Material Storage Area

Material organized and rotated by date

Material not triple stacked, only two high

Flammable Cabinets

Only flammable liquids in cabinet (no paper, wood or plastic stored in cabinet)

Cabinets undamaged

No more than 3 cabinets within 100 square feet

Environmental

Are all areas free from spills?

Machine Guarding

Is point of operation (grinding wheel, etc.) protected such that inadvertent contact is prevented?

Flywheels, gears, shafts, pulleys, belts, gears, sprockets, chains and couplings guarded to protect employees

E-stop button present

Walking / Working surfaces

Are the walkways clear and free of debris

Are all holes or floor openings guarded?

Fire Extinguishers

Monthly Inspection completed / Verify completely charged

Confined space

Marked with proper signage (permit required sign or non permit required sign

HAZCOM

All containers labeled. (Original container with Manufacturers Label or secondary container with HMIS label)

Do employees know how to access an MSDS for a chemicals used?

Lockout / Tagout

Is machine specific energy control procedure present?

Are LOTO labels present

Compressed Air Nozzles

Are nozzles labeled as OSHA compliant. (regulate air pressure to 30psi or less)

Compressed Gas Cylinder Storage

Are cylinders identified with a durable label that clearly identifies the cylinder contents and gives a brief description of the potential hazard?

Cylinders secured with chain, lab strap or hard stock device located on the upper one third of the cylinder

Nesting methods for storage are prohibited. Acceptable means of storage include individual chains or straps, holding racks, cylinder carts etc.

Flammable gasses shall be stored at least 20 feet from oxidizers and any other source of ignition or separated by an approved firewall

OE and Standard Work

Material consumption be tracked PP/T?

Are 5S audits and Safety audits posted and current

Observe if standard work is being followed

Area clean & organized (less than 1 day of dirt)?

Aisles and emergency exits not blocked?

Do the employees know: (Interview a few people)

How to report suggestions

Who to report incident or injuries to and how long they have to do it in "as soon as it happens"

How to do and R3 and what it is

What is standard work and where is it located

What do they do if they find a problem

What a STOP card is and do they have them available

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Frequently asked questions

What are the best practices for adopting safety Gemba walks in a new organization?

Educate your team on the importance of safety Gemba walks and provide training on using the template. Set clear objectives, establish a consistent schedule, and encourage open communication. Leadership support and regular feedback sessions are crucial to successful adoption and integration into the organizational culture.

How can you ensure that safety Gemba walks are effective?

Ensure that safety Gemba walks are well-planned, with clear objectives and thorough checklists. Engage employees in the process, provide necessary training, and follow up on identified issues with timely actions. Regular reviews and adjustments based on feedback help maintain their effectiveness.

How do you measure the effectiveness of safety Gemba walks?

Track key performance indicators (KPIs) such as the number of safety incidents, compliance rates, and employee feedback. Regularly review the outcomes of safety Gemba walks and make adjustments as needed to enhance their impact. Improved safety metrics indicate the success of the walks.

This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.