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DFSS - Environmental Health & Safety​
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UCSB SELF-INSPECTION CHECKLIST: ART GALLERY & MUSEUM
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Under California law (OSHA Injury and Illness Prevention Program), and UCSB campus policy #5400, campus supervisors are responsible for ensuring regular safety inspections are documented.
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The list provided may not contain every possible hazard, but is a generalized set of guidelines.
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Department/work unit: __________________________________________________________________________________________________________________________________
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Building: ________________________________________________________________________ Room: ______________________________________________________
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Inspector name: _______________________________________________________________________________________________________________________________________
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Inspector email: _____________________________________________________ Inspector phone: _______________________________________________________________
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Inspection date: _____/ _____/ ________
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0.0REVIEW OF PRIOR ACTION ITEMS
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Item #ItemYesNoN/ANOTES (Include Room # and Description)CORRECTIVE ACTION COMPLETED (date, WO# if applicable)
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0.1All previously identified action items have been corrected and noted on the corresponding inspection form.
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0.2Previously identified issues are not recurring.
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*** If issues are recurring, a new corrective action must be opened in each inspection. If issues have recurred more than 3 times, greater action must be taken to prevent the recurrence.
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1.0EMERGENCY
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Item #ItemYesNoN/ANOTES (Include Room # and Description)CORRECTIVE ACTION COMPLETED (date, WO# if applicable)
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1.1The emergency flip-chart is updated with building specific information, and is posted in every laboratory, loading dock, gathering area, storage room and in many office spaces.
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1.2Emergency pull stations are unobstructed and wheelchair accessible.
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1.3Exits are free of obstructions, properly marked and correctly illuminated.
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1.4Emergency lighting is operational.
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1.5Is there anything else relating to Emergency that needs attention at this time? Please note in the comments.
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2.0WALKWAY, SLIP/TRIP/FALL & EVACUATION SAFETY
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Item #ItemYesNoN/ANOTES (Include Room # and Description)CORRECTIVE ACTION COMPLETED (date, WO# if applicable)
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2.1All walkways and doorways are clear of obstruction. Where employees are protected by the Americans with Disabilities Act (ADA), exit access for aisles must be at least 36 inches (3 feet) wide.
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2.2Aisles and doorways are free of obstruction.
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2.3Storage items are stored away from walkways and gathering areas.
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2.4Items are stored where they will not create hazard for lifting or tripping.
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2.5Is there anything else relating to Walkway, Slip/Trip/Fall & Evacuation Safety that needs attention at this time? Please note in the comments.
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3.0FIRE SAFETY
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Item #ItemYesNoN/ANOTES (Include Room # and Description)CORRECTIVE ACTION COMPLETED (date, WO# if applicable)
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3.1A clear path leading up to Fire Extinguishers and electrical panels is maintained, with a minimum of 36” of space in front and under at all times.
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3.2All items (storage, furniture, etc.) are kept a minimum of 18” away, in all directions, from the sprinkler heads, and 18 inches horizontally from the ceiling, at all times.
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3.3Flammable objects such as books, paper, and other materials are not in contact with outlets and power bars.
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3.4Personal space heaters are approved by the department, are UL listed, are placed on the floor and are not placed within 3 feet of combustible materials.
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3.5Is there anything else relating to Fire Safety that needs attention at this time? Please note in the comments.
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4.0EARTHQUAKE & FALLING OBJECT PREPAREDNESS
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Item #ItemYesNoN/ANOTES (Include Room # and Description)CORRECTIVE ACTION COMPLETED (date, WO# if applicable)
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4.1All furnishings and equipment (book cases, file cabinets and other large items) over 42 inches in height are fastened to a wall or floor in a manner to prevent falling in an earthquake.
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4.2All large, heavy or angular items are stored below 42 inches, or are secured.
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4.3All shelves and/or storage above 42 inches have a lip or other method to secure items from falling.
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4.4Is there anything else relating to Earthquake & Falling Object Preparedness that needs attention at this time? Please note in the comments.
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5.0ELECTRICAL SAFETY
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Item #ItemYesNoN/ANOTES (Include Room # and Description)CORRECTIVE ACTION COMPLETED (date, WO# if applicable)
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5.1Power bars, power cords, multi plug adapters and/or extension cords are not stacked together, interconnected, or daisy-chained.
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5.2Extension cords are in good condition without damage, splices, or being sharply bent or pinched.
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5.3Power cords are kept tidy to avoid fire hazard, possible shock or electrocution, and for general safety.
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5.4In the event a power cord or cable must cross an aisle, or other walkway, an ADA-compliant cord guard is provided. Power cords must never be placed under a rug or carpet. If possible, reroute the power cord or cable entirely and get it off the floor.
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5.5Electrical panels must have a clear path leading up to the panels, and a minimum of 36 minches maintained in front of the panels, at all times for safety and to allow access.
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5.6Electrical panel door is clearly identified.
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5.7Circuit breaker switches are identified with each circuit they control.
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5.8All outlets are in good condition and do not have cracked plates, or signs of electrical charring.
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5.9Is there anything else relating to Electrical Safety that needs attention at this time? Please note in the comments.
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6.0SECURITY
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Item #ItemYesNoN/ANOTES (Include Room # and Description)
CORRECTIVE ACTION COMPLETED (date, WO# if applicable)
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6.1Access to the Art Gallery / Museum is monitored.
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6.2Video monitoring equipment is in working condition and is strategically placed.
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6.3Minimum cash/banking is being carried out.
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6.4Is there anything else relating to Security that needs attention at this time? Please note in the comments.
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7.0ADDITIONAL REQUIREMENTS & BEST PRACTICES
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Item #ItemYesNoN/ANOTES (Include Room # and Description)CORRECTIVE ACTION COMPLETED (date, WO# if applicable)
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7.1When not in use, all sharp objects and blades are safely closed, sheathed, or properly stored.
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7.2Employees have documented training on safe use of the electric hand tools they use; including the requirement of proper personal protective equipment like safety glasses.
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7.3Ladders in storage are secured on racks or with a chain.
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7.4Ladder safety training is completed and documented prior to use of ladders.
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7.5Areas are properly cordoned off during the process of changing out shows / exhibits, with signs at the reception areas if needed.
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7.6During deliveries, employees are strategically placed to protect workers from oncoming skateboarders or bicyclists.
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7.7A clear path is maintained to the first aid kit. Kit is clean and free of expired products. Note: OSHA does not have a minimum requirement for general use first aid kits (non-lab). It is acceptable to assess the potential hazards of the work area and place into the first aid kit only the items that apply to those specific hazards. If assistance is needed in determining appropriate first aid kit contents, please reference the non-mandatory ANSI standard (ANSI Z308.1-2003 Minimum Requirements for Workplace First Aid Kits) or contact EH&S.
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7.8No food or beverage is allowed within gallery or museum.
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7.9All employees who operate electric pallet jacks have a current certification provided by UCSB EH&S
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7.10The ceiling and walls show no moisture, leaks, water damage or discoloration.
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7.11Is there anything else relating to Additional Requirements and Best Practices that needs attention at this time? Please note in the comments.
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PRINT NAME
SIGNATURE
DATE
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_______/ _______/ ____________
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DATE SUBMITTED TO EH&S
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