TEMPLATE
California workplace safety inspection report template
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Your California workplace safety inspection report has 5 rules to meet. ReportDraft puts every one on your checklist and checks your draft before you sign.
- Scheduled periodic inspections under your Injury and Illness Prevention Program
- Keep this inspection record at least one year
A workplace safety inspection report template set up for California, with fields for the reason for this inspection. In Word and PDF.
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California Workplace safety inspection Template
Workplace or business name
Areas or departments inspected
Inspection date
Inspected by
Reason for this inspection
Download in Word or PDFIncluded with ReportDraft Safety and its free trial.
Set up for California
- The record of each scheduled periodic inspection includes the person or persons conducting itCal. Code Regs., tit. 8, s. 3203 (b) (1)
Also required in California
These rules are about how and when you report, not the template's fields. Check them before you deliver.
- Every employer's written Injury and Illness Prevention Program includes procedures for identifying and evaluating workplace hazards, including scheduled periodic inspections to identify unsafe conditions and work practicesCal. Code Regs., tit. 8, s. 3203 (a) (4) · Cal. Labor Code s. 6401.7 (a) (2)
- Inspections are also made when the program is first established, whenever new substances, processes, procedures or equipment bring a new hazard to the workplace, and whenever the employer learns of a new or previously unrecognized hazardCal. Code Regs., tit. 8, s. 3203 (a) (4) (A) to (C)
- The inspection record includes the unsafe conditions and work practices identifiedCal. Code Regs., tit. 8, s. 3203 (b) (1)
- The inspection record includes the action taken to correct the identified unsafe conditions and work practicesCal. Code Regs., tit. 8, s. 3203 (b) (1)
- Inspection records are kept for at least one year (employers with fewer than 10 employees may keep them only until the hazard is corrected)Cal. Code Regs., tit. 8, s. 3203 (b) (1) and exception
- Unsafe or unhealthy conditions and work practices are corrected in a timely manner based on the severity of the hazard; when an imminent hazard cannot be abated at once without endangering people or property, all exposed personnel leave the area except those needed to correct it, with the necessary safeguardsCal. Code Regs., tit. 8, s. 3203 (a) (6) · Cal. Labor Code s. 6401.7 (b)
- An employer that uses a labor/management safety and health committee for communication has it meet at least quarterly and review the results of the periodic, scheduled worksite inspectionsCal. Code Regs., tit. 8, s. 3203 (c) (1), (3)
What is in it
- Housekeeping and walking surfacesFloors, aisles and walkways clear, dry and in good repair, Stairs, handrails and guardrails, Storage, stacking and racking stable, Lighting adequate for the work
- Exits and emergency equipmentExit routes and exit doors clear, unlocked and marked, Exit signs and emergency lighting working, Emergency plan, alarms and assembly point posted and known, Eyewash stations and emergency showers where needed
- Fire preventionFire extinguishers in place, charged, inspected and unobstructed, Flammable and combustible materials stored safely, Sprinkler heads clear, with storage kept below them, Compressed gas cylinders secured and capped
- ElectricalElectrical panels closed, labeled and with clear access, Extension cords and power strips used properly and undamaged, Outlets, switches and cover plates; GFCI protection near water
- Machinery, tools and powered equipmentMachine guards in place and working, Lockout and tagout devices and procedures available and used, Hand and power tools in good condition, Forklifts and powered equipment: daily checks done, operators trained
- Hazardous productsContainers labeled, Safety data sheets current and available, Chemicals stored and separated safely; spill supplies on hand, Ventilation and exhaust working
- Personal protective equipmentRequired PPE available and in good condition, PPE worn where required
- Ladders, heights and material handlingLadders and step stools in good condition and used correctly, Work at height: guardrails or fall protection, Manual lifting and workstation ergonomics
- First aid, postings and recordsFirst aid kits stocked; first aid attendants or trained workers available, Required safety postings and notices displayed
- Corrective actionsHazard and location, Corrective action, Responsible, Due, Status
- Items from earlier inspectionsItems from earlier inspections or reports, and whether each has been fixed.
Rules last reviewed October 11, 2026. Read the full California workplace safety inspection report requirements.