6S Safety Audit Form

CATEGORY
Sort
Sort Through &
Discard Unused
1S
Items

CRITERIA
Distinguish between what is needed and not needed
Procedures are established to identify unnecessary items
Unneeded equip., storage, furniture, etc. exist
Unneeded items on walls / bulletin boards, etc. exist
Aisles, stairways, corners etc. are free of items
Unneeded inventory, supplies, parts, or materials exist (drawers /
cabinets / work surfaces / storage areas)

Set in Order

AUDIT PERIOD
1

A place for everything and everything in its place

All items have a specific location
Use Labels, Lines, Shared drawers, cabinets, work surfaces, and storage areas are clearly
Signs & Colors to labeled and well organized
2S identify Normal vs. Personal drawers, cabinets, desktops, and storage areas are clearly
marked and/or well organized
Abnormal
Conditions
All items are placed in the proper location
Aisleways, workstations, equipment locations are identified

Shine
Routine discipline maintaining a clean and organized workplace
Cleaning is a
Equipment, computers, work surfaces, and storage areas are clean
Method of
Garbage and recyclables are collected and disposed correctly
3S Inspection, Look
Paper are filed daily
for Hidden Defects
Shared areas are cleaned and maintained regularly

Standardize

Preventing the area from having abnormal operating conditions

Specific cleaning and organizing tasks have been developed and
Standardize the assigned for the work area
4S Rules to Make 5S a Staff is trained and fully understands 6S procedures
Habit
6S standards are clearly displayed
Visual management tools identify if work is complete
Sustain

Stick to the rules (self-discipline)

Everyone
is
involved
in the improvement activities
Sustaining plans
Standardized
cleaning
and work procedures are followed
are developed to
5S
ensure
6S documentation and instructions are current
accountability
6S audits occur regularly
Comments

SCORING SYSTEM

Scale / # Problems
Outstanding
Above Average
Average
Below Average

Poor

3
3

4
4
4
4

3
3
2
2
2
2

SHEET SUMMARY
Average Scores

Tot

1S

Sort

18

2S

Set in Order

13

3S
4S
5S

Shine
Standardize
Sustain

2
3
3

3
3
2

3
2
2

3
3
2

0
0
0

11
11
9

5
Overall Scale

3
3
3
1

3
3

1S
2S
3S
4S

Sort
Set in Order
Shine
Standardize

5S

Sustain
Standardized
Sustain

2
3
1

2
2
2
2

Rating / Score
5
4
3
2

3
3

Area Audited:
Auditor:

Rating / Score
2
3
4
X
X
X
X
X

Comments

6S Safety Audit Form

6S Safety Audit Form

CATEGORY
Sort
Sort Through &
Discard Unused
1S
Items

CRITERIA
Distinguish between what is needed and not needed
Procedures are established to identify unnecessary items
Unneeded equip., storage, furniture, etc. exist
Unneeded items on walls / bulletin boards, etc. exist
Aisles, stairways, corners etc. are free of items
Unneeded inventory, supplies, parts, or materials exist (drawers /
cabinets / work surfaces / storage areas)

Set in Order

AUDIT PERIOD
1

Shine
Routine discipline maintaining a clean and organized workplace
Cleaning is a
Equipment, computers, work surfaces, and storage areas are clean
Method of
Garbage and recyclables are collected and disposed correctly
3S Inspection, Look
Paper are filed daily
for Hidden Defects
Shared areas are cleaned and maintained regularly

Preventing the area from having abnormal operating conditions

Specific cleaning and organizing tasks have been developed and
Standardize the assigned for the work area
4S Rules to Make 5S a Staff is trained and fully understands 6S procedures
Habit
6S standards are clearly displayed
Visual management tools identify if work is complete
Sustain

Stick to the rules (self-discipline)

Everyone
is
involved
in the improvement activities
Sustaining plans
Standardized
cleaning
and work procedures are followed
are developed to
5S
ensure
6S documentation and instructions are current
accountability
6S audits occur regularly
Comments

4
4
4
4
4

SCORING SYSTEM
5

A place for everything and everything in its place

All items have a specific location
Use Labels, Lines, Shared drawers, cabinets, work surfaces, and storage areas are clearly
Signs & Colors to labeled and well organized
2S identify Normal vs. Personal drawers, cabinets, desktops, and storage areas are clearly
marked and/or well organized
Abnormal
Conditions
All items are placed in the proper location
Aisleways, workstations, equipment locations are identified

Standardize

4
4

4
4
3
3

4
4
4
4

4
4
4
4

SHEET SUMMARY
Average Scores

Tot

1S

Sort

19

2S

Set in Order

19

3S
4S
5S

Shine
Standardize
Sustain

4
4
4

4
4
4

4
4
4

3
3
3

0
0
0

15
15
15

4
4
4
3
1

Overall Scale

3
1

Rating / Score
5
4
3
2

Poor

Scale / # Problems
Outstanding
Above Average
Average
Below Average

1S
2S
3S
4S

Sort
Set in Order
Shine
Standardize

5S

Sustain
Standardized
Sustain

Area Audited:
Auditor:

Rating / Score
2
3
4
X
X
X
X
X

Comments

6S Safety Audit Form

6S Safety Audit Form

CATEGORY
Sort
Sort Through &
Discard Unused
1S
Items

CRITERIA
Distinguish between what is needed and not needed
Procedures are established to identify unnecessary items
Unneeded equip., storage, furniture, etc. exist
Unneeded items on walls / bulletin boards, etc. exist
Aisles, stairways, corners etc. are free of items
Unneeded inventory, supplies, parts, or materials exist (drawers /
cabinets / work surfaces / storage areas)

Set in Order

AUDIT PERIOD
1

Shine
Routine discipline maintaining a clean and organized workplace
Cleaning is a
Equipment, computers, work surfaces, and storage areas are clean
Method of
Garbage and recyclables are collected and disposed correctly
3S Inspection, Look
Paper are filed daily
for Hidden Defects
Shared areas are cleaned and maintained regularly

Preventing the area from having abnormal operating conditions

Specific cleaning and organizing tasks have been developed and
Standardize the assigned for the work area
4S Rules to Make 5S a Staff is trained and fully understands 6S procedures
Habit
6S standards are clearly displayed
Visual management tools identify if work is complete
Sustain

Stick to the rules (self-discipline)

Everyone
is
involved
in the improvement activities
Sustaining plans
Standardized
cleaning
and work procedures are followed
are developed to
5S
ensure
6S documentation and instructions are current
accountability
6S audits occur regularly
Comments

SCORING SYSTEM
5

Scale / # Problems
Outstanding
Above Average
Average
Below Average

Poor

A place for everything and everything in its place

All items have a specific location
Use Labels, Lines, Shared drawers, cabinets, work surfaces, and storage areas are clearly
Signs & Colors to labeled and well organized
2S identify Normal vs. Personal drawers, cabinets, desktops, and storage areas are clearly
marked and/or well organized
Abnormal
Conditions
All items are placed in the proper location
Aisleways, workstations, equipment locations are identified

Standardize

2
2
2

2
2

2
2
2
2
2

3
3
3

Tot

1S

Sort

11

2S

Set in Order

10

3S
4S
5S

Shine
Standardize
Sustain

3
2
2

3
3
2

2
2
2

3
2
2

0
0
0

11
9
8

1S
2S
3S
4S

Sort
Set in Order
Shine
Standardize

5S

Sustain
Standardized
Sustain

2
2
2
2
2
2
2

SHEET SUMMARY
Average Scores

Overall Scale

3
2

Rating / Score
5
4
3
2

Area Audited:
Auditor:

Rating / Score
2
3
4
X
X
X
X

Comments

6S Safety Audit Form

6S Safety Audit Form

CATEGORY
Sort
Sort Through &
Discard Unused
1S
Items

CRITERIA
Distinguish between what is needed and not needed
Procedures are established to identify unnecessary items
Unneeded equip., storage, furniture, etc. exist
Unneeded items on walls / bulletin boards, etc. exist
Aisles, stairways, corners etc. are free of items
Unneeded inventory, supplies, parts, or materials exist (drawers /
cabinets / work surfaces / storage areas)

Set in Order

AUDIT PERIOD
1

Stick to the rules (self-discipline)

Everyone
is
involved
in the improvement activities
Sustaining plans
Standardized
cleaning
and work procedures are followed
are developed to
5S
ensure
6S documentation and instructions are current
accountability
6S audits occur regularly
Comments

SCORING SYSTEM
5

Shine
Routine discipline maintaining a clean and organized workplace
Cleaning is a
Equipment, computers, work surfaces, and storage areas are clean
Method of
Garbage and recyclables are collected and disposed correctly
3S Inspection, Look
Paper are filed daily
for Hidden Defects
Shared areas are cleaned and maintained regularly

Sustain

Preventing the area from having abnormal operating conditions

Specific cleaning and organizing tasks have been developed and
Standardize the assigned for the work area
4S Rules to Make 5S a Staff is trained and fully understands 6S procedures
Habit
6S standards are clearly displayed
Visual management tools identify if work is complete

3
3

2
2

A place for everything and everything in its place

All items have a specific location
Use Labels, Lines, Shared drawers, cabinets, work surfaces, and storage areas are clearly
Signs & Colors to labeled and well organized
2S identify Normal vs. Personal drawers, cabinets, desktops, and storage areas are clearly
marked and/or well organized
Abnormal
Conditions
All items are placed in the proper location
Aisleways, workstations, equipment locations are identified

Standardize

2
2

3
2
2
3

SHEET SUMMARY
Average Scores

Tot

1S

Sort

12

2S

Set in Order

13

3S
4S
5S

Shine
Standardize
Sustain

2
3
2

4
4
2

3
3
4

3
3
2

0
0
0

12
13
10

5
Overall Scale

3
3
1

3
4

3
2

Sort
Set in Order
Shine
Standardize

5S

Sustain

Area Audited:
Auditor:

4
2

1S
2S
3S
4S

Standardized
Sustain

3
3
1

Rating / Score
5
4
3
2

Poor

2
2

Scale / # Problems
Outstanding
Above Average
Average
Below Average

Rating / Score
2
3
4
X
X
X
X

Comments

6S Safety Audit Form

1S
2S
3S
4S
5S

Zone A
18
13
11
11
9

Zone B
19
19
15
15
15

Zone C
11
10
11
9
8

Zone D
12
13
12
13
10

Audit No.: 3

Head Office - Overall Audit Score

Month: Aug 2013

Zone A
20

10
1
S
Zone D

Zone B

2
S
3
S

Zone C

Month: Aug 2013

Zone B

1
S
2
S
3
S

Audit No.: 3

Head Office - Overall Audit Score

Month: Aug 2013

20
18
16
14
12
10

1
S

2
S

3
S

4
2
0

Zone A

Zone B

Zone C

Zone D

Month: Aug 2013

eD

1
S
2
S
3
S