PPE Compliance Safety Checklist

This checklist is designed to ensure that all employees are using the appropriate personal protective equipment (PPE) for the task at hand and that the PPE is in good working condition. It is important to complete this checklist before beginning any work task and to address any issues immediately.

Instructions: Complete this checklist before starting work. Mark "Yes" if the item is compliant, "No" if it is not, and "N/A" if it is not applicable to the task. If any item is marked "No", take corrective action immediately.

I. General Requirements

• 1. Has a hazard assessment been performed to determine required PPE?
  • Corrective Actions:
• 2. Is a written PPE program in place and readily available?
  • Corrective Actions:
• 3. Are employees trained on the proper use, maintenance, and storage of PPE?
  • Corrective Actions:
• 4. Is training documentation up to date?
  • Corrective Actions:
• 5. Are appropriate hygiene measures observed, such as washing hands after working with substances? 8, 17, 20
  • Corrective Actions:

II. Head Protection

• 1. Is head protection required for the task?
  • Corrective Actions:
• 2. If yes, are hard hats ANSI approved and in good condition (no cracks, dents, or damage)?
  • Corrective Actions:
• 3. Are hard hats properly fitted?
  • Corrective Actions:

III. Eye and Face Protection

• 1. Is eye/face protection required for the task? 3, 5, 6, 7, 13, 16, 17, 20
  • Corrective Actions:
• 2. If yes, are safety glasses or goggles ANSI approved?
  • Corrective Actions:
• 3. Are safety glasses/goggles clean and free from scratches?
  • Corrective Actions:
• 4. If a face shield is required, is it in good condition? 3, 7, 13
  • Corrective Actions:
• 5. Is proper eye wash readily available? 3, 7
  • Corrective Actions:

IV. Hand Protection

• 1. Is hand protection required for the task? 1, 3, 5, 6, 7, 13, 14, 15, 16, 17, 19, 20
  • Corrective Actions:
• 2. Are gloves appropriate for the specific hazard (chemical, cut, abrasion, etc.)? 1, 5, 6, 14, 16, 17, 19, 20
  • Corrective Actions:
• 3. Are gloves in good condition (no tears, punctures, or degradation)?
  • Corrective Actions:
• 4. For chemical handling, are gloves made of suitable materials (e.g., Polychloroprene, Nitrile rubber, Butyl rubber, Fluorinated rubber) with appropriate thickness and breakthrough time? 1, 5, 6, 16, 17, 19, 20
  • Corrective Actions:

V. Body Protection

• 1. Is appropriate body protection required (clothing, aprons, etc.)? 1, 3, 5, 6, 7, 13, 14, 15, 16, 17, 19, 20
  • Corrective Actions:
• 2. Is the clothing made of appropriate material (e.g. cotton, rubber, PVC or viton) for the hazard? 1, 5, 6
  • Corrective Actions:
• 3. Is clothing clean and in good condition?
  • Corrective Actions:

VI. Foot Protection

• 1. Is foot protection required for the task?
  • Corrective Actions:
• 2. If yes, are safety shoes or boots ANSI approved?
  • Corrective Actions:
• 3. Are safety shoes/boots in good condition?
  • Corrective Actions:
• 4. Are they appropriate for the hazard (slip, impact, puncture, electrical)?
  • Corrective Actions:

VII. Respiratory Protection

• 1. Is respiratory protection required? 1, 3, 5, 6, 12, 14, 15, 16, 17, 18, 20
  • Corrective Actions:
• 2. If yes, has the employee been fit-tested for the respirator? 14, 15, 16, 17, 18, 20
  • Corrective Actions:
• 3. Is the respirator NIOSH approved? 3, 7, 8, 10, 14, 16
  • Corrective Actions:
• 4. Is the respirator clean and in good working condition?
  • Corrective Actions:
• 5. Is the correct filter or cartridge being used for the hazard?
  • Corrective Actions:

VIII. Hearing Protection

• 1. Is hearing protection required?
  • Corrective Actions:
• 2. If yes, are earplugs or earmuffs clean and in good condition?
  • Corrective Actions:
• 3. Are earplugs properly inserted, or earmuffs properly fitted?
  • Corrective Actions:

IX. Other PPE

• 1. Is any other specialized PPE required for the task (e.g., fall protection, high-visibility clothing)?
  • Corrective Actions:
• 2. Is the specialized PPE in good working condition and properly inspected?
  • Corrective Actions:

Completed by:

Name: __________________________

Signature: ______________________

Date: __________________________

Supervisor Review:

Name: __________________________

Signature: ______________________

Date: __________________________