PLS Office 5S + Safety Audit Form - Draft

CATEGORY CRITERIA AUDIT PERIOD SCORING SYSTEM

Sort Distinguish between what is needed and not needed 1 2 3 4 Scale / # Problems Rating / Score
Procedures are established to identify unnecessary items High - 5 or more 0
Unneeded equip., storage, furniture, etc. exist 3-4 1
Sort Through & Discard Unneeded items on walls / bulletin boards, etc. exist 2 2
Unused Items Aisles, stairways, corners etc. are free of items 1 3
Unneeded inventory, supplies, parts, or materials exist (drawers / cabinets /
work surfaces / storage areas) Low - None 4

Set in Order A place for everything and everything in its place 1 2 3 4 SHEET SUMMARY
All items have a specific location Average Scores 1 2 3 4
Use Labels, Lines, Shared drawers, cabinets, work surfaces, and storage areas are clearly
Signs & Colors to labeled and well organized Sort 0.0 0.0 0.0 0.0
identify Normal vs. Personal drawers, cabinets, desktops, and storage areas are clearly
Abnormal Conditions marked and/or well organized Set in Order 0.0 0.0 0.0 0.0
All items are placed in the proper location Shine 0.0 0.0 0.0 0.0
Aisleways, workstations, equipment locations are identified Standardize 0.0 0.0 0.0 0.0
Sustain 0.0 0.0 0.0 0.0
Shine Routine discipline maintaining a clean and organized workplace 1 2 3 4 Total Average Score 0.0 0.0 0.0 0.0
Equipment, computers, work surfaces, and storage areas are clean
Cleaning is a Method of Garbage and recyclables are collected and disposed correctly
Inspection, Look for E-mails and paper are filed daily
Hidden Defects
Shared areas are cleaned and maintained regularly Average Scores Q1 Q2 Q3 Q4
Sort 0 0 0 0
Standardize Preventing the area from having abnormal operating conditions 1 2 3 4 Set in Order 0 0 0 0
Specific cleaning and organizing tasks have been developed and assigned
for the work area Shine 0 0 0 0
Standardize the Rules Staff is trained and fully understands 5S procedures Standardized 0 0 0 0
to Make 5S a Habit
5S standards are clearly displayed Sustain 0 0 0 0
Visual management tools identify if work is complete

Sustain Stick to the rules (self-discipline) 1 2 3 4 Area Audited:

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

Comments
 Office 5S A
There are 0 open action items

Objective :

Code: A- Action; R - Recommendation; S - Statement

Status: O - Open; C - Complete
Item Current
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Office 5S Action Plan

Resp Start End Date

Date Closed Status
Primary Date
Remarks / Comments
 RED TAG
ISSUE OR PROBLEM: TAG #

ACTION NEEDED (circle one and note comments if necessary):

1: Throw Away 2: Organize 3: Improve 4: Resolve 5: Other

DATE OF TAG: CATEGORY (if appropriate): DATE OF COMPLETION:

TAGGED BY: ASSIGNED TO: REVIEWED BY:

ACTION TAKEN:

RED TAG
ISSUE OR PROBLEM: TAG #

ACTION NEEDED (circle one and note comments if necessary):

1: Throw Away 2: Organize 3: Improve 4: Resolve 5: Other

DATE OF TAG: CATEGORY (if appropriate): DATE OF COMPLETION:

TAGGED BY: ASSIGNED TO: REVIEWED BY:

ACTION TAKEN:
 RED TAG ITEMS LOG

Tag
Item Tagged Reason for Tagging Notes / Disposition
Number

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 5S MATURITY LEVE
MATURITY
LEVEL SORT SET IN ORDER SHINE
Employees are continually Anyone can walk into the work Area employees have devised
seeking improvement area and easily locate items. a dependable and documented
opportunities. Abnormal conditions are method of preventive cleaning
LEVEL 5 visually obvious and corrective and maintenance. Work area
Focus on #DIV/0!
action measures are in place. #DIV/0!
cleanliness and organization #DIV/0!

Prevention are a way of life.

A dependable documented A dependable and documented 5S schedules detailing tasks

method has been established method has been established and responsibilities are
to maintain a work area free of to recognize, with a visual understood and practiced.
LEVEL 4 unnecessary items. sweep, if items are out of place
Focus #DIV/0!

or exceed quantity limits. #DIV/0! #DIV/0!

on Consistency

All unnecessary items have Designated locations are 5S schedules detailing tasks
been removed from the work marked to make organization and responsibilities are
LEVEL 3 area. more visible. developed and utilized.
Make It #DIV/0! #DIV/0! #DIV/0!

Visual

Necessary and un-necessary A designated location has been Workplace areas are cleaned
items are separated. established for all items. on a regularly scheduled basis.
LEVEL 2
Focus #DIV/0! #DIV/0! #DIV/0!

on Basics

Necessary and unnecessary Tools, supplies, books and Workplace areas are dirty and
items are mixed together in the materials are randomly disorganized.
LEVEL 1 work area. located.
Just #DIV/0! #DIV/0! #DIV/0!

Beginning
ATURITY LEVEL SUMMARY
STANDARDIZE SUSTAIN
Employees are continually Employees maintain consistent
seeking the elimination of standards in compliance with
waste, all changes are the 5S program.
documented and information is
shared with employees. #DIV/0! #DIV/0!

Workplace method Checklists exist showing that

improvements are visible and employees follow through on
understood by all employees. 5S schedules.
#DIV/0! #DIV/0!

Workplace method 5S schedules detailing tasks

improvements are being and responsibilities have been
incorporated and documented. developed and are utilized.
#DIV/0! #DIV/0!

Workplace methods are being A recognized effort has been

improved, but changes have made to improve the condition
not been documented. of the work environment.
#DIV/0! #DIV/0!

No attempt is being made to Minimal attention is spent on

document or improve current housekeeping.
processes.
#DIV/0! #DIV/0!
ARY
IMPROVEMENT INITIATIVES
 Trend Data
Period Goal Rating
1 0.0
2 0.0
3 0.0
4 0.0
Fill in your goals for each period
 Office 5S

Sort

4.0

Average Rating
3.5
3.0
2.5 5S Perfromance
2.0
Sustain
1.5 Set in Order

1.0 1
0.5
0.0

0.5

Standardize Shine 0
1 2 3 4
Period
Goal Rating

Current Average Score 0.00

 Office 5S

Average Rating
Sort

4.0
5S + Safety
3.0 FY05 Perfromance Trend
Sustain 2.0 Set in Order
1.0 1

0.0

0.5

Standardize Shine

0
1 2 3 4
Period
Goal Rating

Current Average Score 0.00

 Office 5S

Average Rating
Sort

4.0
5S + Safety
3.0 FY05 Perfromance Trend
Sustain 2.0 Set in Order
1.0 1

0.0

0.5

Standardize Shine

0
1 2 3 4
Period
Goal Rating

Current Average Score 0.00

 Office 5S

Average Rating
Sort

4.0 5S + Safety
FY05 Perfromance Trend
3.0
Sustain 2.0 Set in Order
1
1.0
0.0

0.5

Standardize Shine

0
1 2 3 4
Period
Goal Rating

Current Average Score 0.00