Workplace Caution Zone Safety Checklist Form
Complete this checklist to document safety conditions and hazard monitoring in the workplace caution zone.
Inspector Name
*
First Name
Last Name
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Caution Zone Location / Area
*
Are hazard warning signs visible and legible?
*
Yes
No
Not Applicable
Is the area free from slip, trip, and fall hazards?
*
Yes
No
Not Applicable
Are required personal protective equipment (PPE) available and in use?
*
Yes
No
Not Applicable
Is emergency access (e.g., exits, fire extinguishers) clear and unobstructed?
*
Yes
No
Not Applicable
Are all tools and equipment in safe working condition?
*
Yes
No
Not Applicable
List any hazards identified or corrective actions required
Additional comments or observations
Submit Checklist
Should be Empty: