5S AUDIT CHECK SHEET

DEPARTMENT:
DATE:
AUDITOR:
TIME:
0 = No Compliance 1 = Very Little Compliance 2 = Some
Compliance 3 = Significant Compliance 4 = Total Compliance

Comments/Action
Determine what is the needed and remove the rest.
0 1 2 3 4

to be taken

SORT

Have all the unnecessary items (tools, machines, boxes, etc.) been
removed from the work place.
Does the inventory include any parts that are not required?
SORT

Are tools and equipment located in the most convenient location?

Do cupboards, storage cabinets, and shelves only contain essential
items?
Is the stockroom area properly managed? (Fully up to date?)

Comments/Action
A place for everything and everything in its place … No searching!
0 1 2 3 4 to be taken

SYSTEMATIZE

Is storage areas clearly defined, labeled, and with location

indicators
SET IN ORDER

in the mast list’s inventory?

Is the storage system used where possible and properly monitored?
Are work ways and work areas are clearly defined and unobstructed?
Are personal belongings stored in lockers provided?
Safety Equipment - is all safety equipment’s in place up to date?

Comments/Action
Cleaning and looking for ways to keep it clean.
0 1 2 3 4 to be taken SHINE
Floors- Are they kept clean, tidy and in good state?
Machines and Tools- Are they free from dirt, visible leaks and
spillage?
SHINE
 Bins- Are they properly maintained and emptied on a regular basis?
Is anyone responsible for routine inspection/maintenance in your
department?
Is your working place clean, tidy and in good working environment
all the time?

Comments/Action STANDARDIZ
Make standards obvious a and maintained
0 1 2 3 4 to be taken E

Is the stock, control, maintained, system established obvious to

all,
and in use?
Is everyone aware of their responsibilities and department flow with
STANDARDIZE

ease?
Is information to carry out daily work routine clear and in use?
Are improvement ideas being generated and regularly acted on?
Are the standards for the first 3S's clear and up to date?

Comments/Actio SUSTAI
Maintain high standards and consistently seek to improve
0 1 2 3 4 n to be taken N
Are checklist available and being used?
SUSTAIN

5S Rules - Is this regularly reviewed and applied?

Have visible improvements from last month?
Training - Is everyone adequately trained to carry out their job
roles?
Education - Can everyone in the area explain the benefits of 5S?

Q25: KNOWLEDGE - Ask 4 employees of the 5 Benefits of 5S (-1 point for each person
that
cannot explain)
DIFFERENCE (+/-) - Compare this month’s score to previous month to see if
improvements DIFFERENCE
are being made.
SCORE

(+/-)
Prepared by: Ma. Kristina N. Pozon - Nurse Supervisor
Criteria Adopted from Ganeshmrgn/ A Technical Knowledge (Reference:
https://ganeshmrgn.wordpress.com/)