This 5S checklist can help you to evaluate how well you are doing in your 5S

process.

5S Rating:
Level 5 - Excellent condition;
Level 4 - Very Good, needs a little more work to attain excellent condition;
Level 3 - Ordinary workshop condition;
Level 2 - Below ordinary workshop condition. Needs positive efforts to correct situation;
Level 1 - Needs to change situation completely.

Department: Evaluator:
Workplace: Type: ( ) Office ( ) Shop Date:
PARTICULARS POINT
A. Floor
1. Clean and dry. 1 2 3 4 5
2. No stain and well-maintained. 1 2 3 4 5
3. Trash cans are provided. 1 2 3 4 5
B. Walls, Windows, Doors, Partitions and Ceiling
1. Free of dust. 1 2 3 4 5
2. No unnecessary posters, pictures, etc. 1 2 3 4 5
3. No writings or graffiti. 1 2 3 4 5
4. Doorknobs and hinges are working well. 1 2 3 4 5
C. Furniture, Tables, Chairs, Forms, Files, Records
1. No damage on upholstery. 1 2 3 4 5
2. Chairs' ball casters are complete and functioning 1 2 3 4 5
well.
3. Free of dust. 1 2 3 4 5
4. Forms, files and records are organized, properly 1 2 3 4 5
arranged, classified, up-to-date, easy to retrieve,
and placed at convenient locations.
5. Bookshelves and steel cabinets are labeled 1 2 3 4 5
properly.
6. Visitors' chairs are provided. 1 2 3 4 5
D. Lighting fixture, Fan / Air Conditioner, Typewriters,
Computers
1. Free of dust. 1 2 3 4 5
2. Adequate for efficient operation. 1 2 3 4 5
3. Fans / air conditioners are operating without 1 2 3 4 5
excessive noise.
4. Computer peripherals (i.e. computer ribbon, 1 2 3 4 5
computer paper, carbon paper, diskettes and
diskette jackets, wiring) are neatly arranged.
5. Convenience outlets, switches, electrical wires 1 2 3 4 5
have no cracks and no exposed wires.
E. Supplies, Products, Tools and Equipment
1. Supplies, materials, parts, components, and 1 2 3 4 5
tools are conveniently located and labeled for easy
stocking and retrieval.
2. Racks are provided for big stock items. 1 2 3 4 5
 3. Bins are provided for small stock items. 1 2 3 4 5
4. Work-in-progress and finished products are 1 2 3 4 5
placed for easy handling, conveniently located,
and properly labeled for easy stocking and
retrieval.
5. Defectives, rejects are labeled for separation 1 2 3 4 5
from good items.
6. Tools, jigs, machines and equipment are placed 1 2 3 4 5
near point of use, clean, well-maintained and
safe.
7. Tools, jigs, spare parts and lubricants are labeled 1 2 3 4 5
and have designated cabinets.
8. Electric wiring is maintained, tidy and safe. 1 2 3 4 5
9. Pipelines have no leak, rust and are labeled 1 2 3 4 5
properly.
10. Containers, pallets, carts and wagons are well- 1 2 3 4 5
maintained and conveniently placed at designated
places.
F. General Appearance and Atmosphere
1. Workshop presents a good and creative 1 2 3 4 5
atmosphere.
G. Others
1. Lockers
a. Free of dust, cigarette butts, etc. 1 2 3 4 5
b. No writings or graffiti on walls and cabinets. 1 2 3 4 5
c. Has proper ventilation. 1 2 3 4 5
d. No cobwebs on ceiling. 1 2 3 4 5
e. Provided with benches and tables. 1 2 3 4 5
f. Cabinets are in good condition. 1 2 3 4 5
g. Clothes are properly hung. 1 2 3 4 5
h. Provided with trash cans. 1 2 3 4 5
i. With proper illumination. 1 2 3 4 5
j. No unnecessary objects on top of steel lockers. 1 2 3 4 5
2. Lifts / conveyors are tidy, well-maintained and 1 2 3 4 5
safe.
3. Conference Room / Training Room
a. Clean and tidy. 1 2 3 4 5
b. Chairs and tables are arranged properly. 1 2 3 4 5
c. Walls are clean and free from unnecessary 1 2 3 4 5
writings.
d. Provided with clean blackboard / whiteboard. 1 2 3 4 5
e. Chairs are sufficient in number. 1 2 3 4 5
f. Erasers and marking pens are provided. 1 2 3 4 5
TOTAL
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