5S AUDIT FORM

Division / Department:

Section / Office / Area:

No. of OFI >4 OFI s 4 OFI s 3 OFI s 2OFI s 1OFI s no OFI s Not Applicable
KEY
Point Value 0 1 2 3 4 5 NA
Note: OFI - Oppor tuni ty for Impr ovement

OFFICE / WORKING AREA Point Value REMARKS/ RESPONSE

1. The following items are free of dust/ dirt

a. Tables ……………………………………………………………………………………………………….

b. Chairs ……………………………………………………………………………………………………….
2. Computers, telephone unit, and other office equipment are clean ……………………………………………

3. All materials / files are properly arranged and organized inside/outside the cabinets ……………………

4. Files are properly labeled and organized ………………………………………………………………………

5. Information in the bulletin board is updated and in order ………………………………………………………

6. W orking table is free of unnecessary materials ………………………………………………………………

7. Floors and walls are clean ………………………………………………………………………………………

8. Aisles and corridors are free of obstruction and clean …………………………………………………………

9. W ires are properly harnessed (no dangling wires) ……………………………………………………………

10. Telephone etiquette is being practiced (Auditor to randomly call the concerned office - 5x) ……………

11. Office personnel smiles or greets you as you greet them ………………………………………………..

PANTRY / KITCHEN

12. No food leftovers and unwashed dishes ………………………………………………………………………

13. Tables, chairs and other kitchen equipment and materials are clean and organized ……………………

CLASSROOM / LABORATORY (Inspect 2 cla ssrooms a nd 1 la boratory w ithout cla sse s)

14. No lecture notes and other writings in black / white board …………………………………………………

15. Chairs and tables are properly arranged ………………………………………………………………………

16. Table, chair, and black / white board tops and edges are free of dust / dirt. ………………………………

Audited by: Conforme:

TOTAL

Signature over printed name & Date Signature over printed name & Date AVERAGE S CORE