Safety Compliance Equipment Assessment Form
Assess workplace safety equipment for compliance and readiness. Please complete all sections to ensure a thorough review.
Assessment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Location / Area Assessed
*
Assessor Name
*
First Name
Last Name
Personal Protective Equipment (PPE) Availability
*
All required PPE available
Some PPE missing
No PPE available
Fire Extinguisher Inspection Status
*
Inspected and operational
Inspection overdue
Not present
First Aid Kit Condition
*
Fully stocked and accessible
Partially stocked
Not present or inaccessible
Emergency Exit Signage Condition
*
Clear and illuminated
Obstructed or not illuminated
Signage missing
Safety Equipment Checklist
*
Rows
Present
Good Condition
Eye Protection
1
2
Hearing Protection
3
4
Respiratory Protection
5
6
Protective Gloves
7
8
Overall Equipment Compliance Rating
*
1
2
3
4
5
Comments / Observations
Recommended Corrective Actions
Submit Assessment
Should be Empty: