Personal Protective Equipment (PPE) Compliance Checklist

Date: 2025-08-03

Inspector: [INSPECTOR NAME]

Location/Area: [LOCATION/AREA]

Department: [DEPARTMENT]

Purpose

To ensure workers are using the correct PPE, that it is in good condition, and that they know how to use it properly, in order to minimize exposure to hazards.

Instructions for Use

1. Review the checklist before beginning work.
2. Inspect all required PPE for damage or defects.
3. Correct any deficiencies before starting work.
4. Document any failed items and corrective actions taken.

Frequency

This checklist should be completed: Daily

Safety Checklist

General PPE Requirements

Item	Pass	Fail	Comments
PPE is appropriate for the hazards present. [1] [5] Check: PPE is selected based on a hazard assessment that identifies potential hazards (physical, chemical, ergonomic, biological). If failed: Conduct a hazard assessment to identify the correct PPE.			_________________
PPE is of safe design and construction. [7] Check: PPE is evaluated to ensure it meets safety standards and is suitable for the work performed. If failed: Replace PPE with equipment that is compliant with safety standards.			_________________
PPE fits the worker properly. [1] Check: PPE is available in multiple sizes and is adjusted to fit each worker. If failed: Provide PPE in various sizes and ensure proper fitting.			_________________
Workers are trained on PPE use. [1] [7] [7] Check: Training records confirm that workers understand when PPE is necessary, what PPE is necessary, how to properly don, doff, adjust, and wear PPE, the limitations of the PPE, and the proper care, maintenance, useful life, and disposal of the PPE. If failed: Provide or repeat PPE training, and document the training.			_________________
PPE is properly maintained and stored. [1] [3] [8] Check: PPE is clean, in good working order, and stored in a designated location when not in use. If failed: Clean, repair, or replace PPE. Provide proper storage.			_________________
PPE is used correctly. [1] Check: Observe workers to confirm that PPE is worn consistently and properly for the task. If failed: Reinforce proper PPE usage through training and supervision.			_________________
Defective PPE is removed from service. [7] Check: Damaged or defective PPE is identified and taken out of service for repair or replacement. If failed: Replace damaged or defective PPE immediately.			_________________

Eye and Face Protection

Item	Pass	Fail	Comments
Appropriate eye protection is used. [9] [10] Check: Safety glasses, goggles, or face shields are used when there is a risk of flying particles, molten metal, liquid chemicals, acids or caustic liquids, chemical gases or vapors, or potentially injurious light radiation. If failed: Provide appropriate eye protection and ensure its use.			_________________
Eye protection provides side protection. [9] Check: Eye protection includes side shields when there is a hazard from flying objects. If failed: Provide eye protection with side shields.			_________________
Prescription eyewear is accommodated. [9] Check: Workers who wear prescription lenses use eye protection that incorporates the prescription or can be worn over the prescription lenses. If failed: Provide appropriate over-the-glasses eye protection or prescription safety glasses.			_________________
Filter lenses are appropriate for the task. [9] Check: Equipment with filter lenses has a shade number appropriate for the work being performed for protection from injurious light radiation (e.g., welding). If failed: Provide filter lenses with the correct shade number.			_________________

Hand Protection

Item	Pass	Fail	Comments
Appropriate gloves are selected. [8] Check: Gloves are selected based on the hazards present (e.g., chemical, cut, flame). If failed: Provide appropriate gloves based on hazard assessment.			_________________
Gloves fit properly. [1] Check: Gloves are available in different sizes and fit the worker's hands properly. If failed: Provide gloves in various sizes and ensure proper fit.			_________________
Gloves are inspected before use. [1] Check: Gloves are checked for punctures, tears, or other damage before each use. If failed: Replace damaged gloves before use.			_________________
Gloves are removed properly. [8] Check: Workers remove gloves in a manner that prevents skin contamination. If failed: Train workers on proper glove removal techniques.			_________________

Head Protection

Item	Pass	Fail	Comments
Safety headgear is worn when required. [10] Check: Hard hats are worn where there is a danger of head injury from falling, flying or thrown objects, or other harmful contacts. If failed: Enforce the use of safety headgear in designated areas.			_________________
Safety headgear meets standards. [10] Check: Safety headgear meets the requirements of CSA Standard CAN/CSA -Z94.1 "Industrial Protective Headwear" or, in the case of emergency response personnel, the applicable National Fire Protection Association Standard. If failed: Replace non-compliant headgear with approved safety headgear.			_________________
Headgear is inspected for damage. [1] Check: Hard hats are inspected for cracks, dents, or other signs of damage before each use. If failed: Replace damaged headgear immediately.			_________________

Respiratory Protection

Item	Pass	Fail	Comments
Respirator is approved for the hazard. [4] Check: The respiratory protective device gives suitable and adequate protection to the worker from one or more airborne contaminants. If failed: Provide an approved respirator appropriate for the hazard.			_________________
Respirator fits properly. [4] Check: The respirator is the proper size for the worker's face and makes an effective seal to the facial skin. If failed: Provide respirators in multiple sizes and conduct fit testing.			_________________
Respirator fit-tested. [4] Check: Respirators requiring a tight fit have been fit-tested by a competent individual in an approved manner. If failed: Conduct fit testing for all workers required to wear tight-fitting respirators.			_________________
Respirator is clean and sanitary. [3] Check: Respirators are cleaned and sanitized regularly. If failed: Implement a respirator cleaning and maintenance program.			_________________

General Requirements

Item	Pass	Fail	Comments
A hazard assessment has been performed to determine the need for PPE. [7] [2] Check: A written hazard assessment identifies potential hazards and the required PPE. If failed: Conduct a hazard assessment.			_________________
A written PPE program is in place. [11] Check: The PPE program includes procedures for hazard assessment, PPE selection, training, maintenance, and program evaluation. If failed: Develop and implement a comprehensive PPE program.			_________________
Workers are involved in PPE selection. [6] Check: Workers have the opportunity to evaluate and provide feedback on different PPE models. If failed: Involve workers in PPE selection and trials.			_________________

Failed Item Procedures

1. Remove the worker from the hazardous situation immediately.
2. Replace or repair the PPE before allowing the worker to continue the task.
3. Retrain the worker on the proper use and maintenance of PPE, if necessary.

Documentation Requirements

Maintain records of hazard assessments, PPE selection, PPE training, and fit testing.

Checklist Completion

Overall Status: ☐ Pass     ☐ Fail     ☐ Corrective Actions Required

Inspector Signature: Date:

Supervisor Review: Date:

Corrective Actions Completed By: Date:

References and Standards

• Refer to local and national regulations regarding PPE requirements.
• Refer to manufacturer's instructions for proper use and maintenance of specific PPE items.

This checklist must be retained for [RETENTION PERIOD].

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