Laboratory Safety Survey - Mercer County Career Center Section 1. Laboratory and Instructor Information Question Title * 1. Program: Question Title * 2. Instructor: Question Title * 3. Start Date and Time: Date / Time Date Time AM/PM - AM PM Section 2. Safety Documentation Question Title * 4. An emergency action plan is posted in the laboratory and classroom. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 5. Emergency phone numbers and procedures are clearly posted. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 6. Safety Data Sheets (SDS) for hazardous materials are available. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 7. Current safety manuals are available in the laboratory, as appropriate. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 8. Standard operating procedures are available for the use of hazardous materials and equipment. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 9. Safety surveys are conducted and documented. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 10. Documentation of student competency for safe machine operation is on file for each student. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Section 3. General Safety Question Title * 11. Appropriate signage is present on the entry door and within the laboratory (i.e., emergency contacts, safety equipment markings). Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 12. Facility access is controlled. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 13. Work practices are performed safely. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 14. Food, beverages, and cosmetics are absent from work areas. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 15. Sink, soap, and towels are available for handwashing. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 16. Instructors and students observe safe clothing procedures. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 17. Suitable personal protective equipment is available, worn, in undamaged condition, and appropriately stored. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Section 4. Fire and Life Safety Question Title * 18. Safety equipment is accessible and operational (e.g., fire extinguishers, panic buttons, and fire blankets). Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 19. An appropriate first aid kit and fire blanket are available. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 20. Eyewash and safety shower are available and unobstructed. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 21. Eyewash station is flushed monthly and documented by a staff member. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 22. Good housekeeping is in evidence. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 23. Aisles and egresses are maintained open and unobstructed. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 24. Room corridor/hallway doors are closed unless held open by magnets. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Section 5. Electrical Safety Question Title * 25. All electrical equipment and cords are properly grounded. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 26. Access to electrical service panels is unobstructed. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 27. Electrical items are used correctly (i.e., cords in good condition, high wattage equipment plugged-in directly, no extension cords, no tandem power strips). Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 28. Specific lockout/tagout procedures are available for equipment. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Section 6. Chemicals and Storage Question Title * 29. Overhead storage is avoided. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 30. Chemical and biological material inventories are current and on file. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 31. Containers (including waste) are appropriately labeled, with names spelled out and closed when not in use. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 32. Incompatible chemicals are stored separately, and all chemicals are stored by their hazard category. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 33. Gas cylinders are secured, away from heat sources, and capped when not in use. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 34. Compressed gas cylinders are labeled. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 35. Oily rags are discarded in a metal waste container with a lid. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 36. An appropriate spill kit or spill control material is available. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Section 7. Equipment Question Title * 37. The condition of the equipment indicates proper care and maintenance. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 38. Tools are kept in good working condition. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 39. Equipment and tools are used in ways consistent with their design. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 40. Machines and power tools are fitted with appropriate guards. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 41. Machines designed for a fixed location are securely anchored. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 42. Bench-top tools are secured to the bench. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 43. Fume hoods are certified annually and used correctly. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 44. The dust or fume collection system is used during activities. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 45. Vacuum equipment is protected with a trap or is filtered correctly. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 46. Ladders are maintained in good condition and inspected regularly. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 47. Compressed air nozzles are provided with a pressure reducing device to restrict pressure to 30 psi. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 48. Refrigeration equipment is appropriately labeled. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 49. Vehicle lifts are inspected annually. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Section 8. Food Safety Question Title * 50. All food is properly wrapped, labeled, and dated. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 51. Temperatures are observable on all coolers and freezers. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 52. A three-compartment sink is properly set-up for ware washing. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 53. All food and paper supplies are stored at least six inches off the floor. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 54. Wiping cloths are stored in a sanitizing solution while in use. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Question Title * 55. No evidence of pests is present. Condition Meets Expectations Condition Needs Improvment Condition Does Not Apply Here Other (please specify) Section 9. Additional Observations Question Title * 56. Additional Comments: Question Title * 57. Exit Interview conducted with instructor? Yes No Question Title * 58. End Date and Time: Date / Time Date Time AM/PM - AM PM Done