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ROOM #:

BUILDING:

LABORATORY MANAGER:

PURPOSE OF LABORATORY:

AREA:

5S EVALUTION FORM

ITEMS FOCUS SCORE


POOR GOOD EXCELLENT
Electric wiring Is it tidy, safety and conveniently
laid out for operation?
Fluorescent light Are they well-maintained, tidy,
safety and conveniently
laid out for operation?
Ceiling fan Are they well-maintained, tidy,
safe?
Windows Are they well-maintained, tidy,
safe?
Working tables Are they tidy and conveniently
organized?
Cabinets/Shelves Are they clean and labeled for the
easy retrieval of things needed?
Hand mixer Are they clean and well-
maintained?
Heavy duty mixer Are they clean and well-
maintained?
Drinkware Are they clean and well-
maintained?
Cookware Are they clean and well-
maintained?
Refrigerator Are they clean and well-
maintained?
Portable fridge- Are they clean and well-
freezer maintained?
LPG gas cylinder/ Are they clean and well-
Gas stove/Range maintained?
stove
Kitchen Equipments Are they clean and well-
maintained?
Kitchen Utensils Are they clean and well-
maintained?
First aid kit It has complete first aid materials
for emergency?
ROOM #: 110

BUILDING: Rice Building

LABORATORY MANAGER: Dr. Felicitas Quilondrino

PURPOSE OF LABORATORY: Food Processing, Baking and Cooking

AREA: Kitchen Area

5S EVALUTION FORM

ITEMS FOCUS SCORE


POOR GOOD EXCELLENT
Electric wiring Is it tidy, safety and conveniently
laid out for operation?
Fluorescent light Are they well-maintained, tidy,
safety and conveniently
laid out for operation?
Ceiling fan Are they well-maintained, tidy,
safe?
Windows Are they well-maintained, tidy,
safe?
Working tables Are they tidy and conveniently
organized?
Cabinets/Shelves Are they clean and labeled for the
easy retrieval of things needed?
Hand mixer Are they clean and well-
maintained?
Heavy duty mixer Are they clean and well-
maintained?
Drinkware Are they clean and well-
maintained?
Cookware Are they clean and well-
maintained?
Refrigerator Are they clean and well-
maintained?
Portable fridge- Are they clean and well-
freezer maintained?
LPG gas cylinder/ Are they clean and well-
Gas stove/Range maintained?
stove
Kitchen Equipments Are they clean and well-
maintained?
Kitchen Utensils Are they clean and well-
maintained?
First aid kit It has complete first aid materials
for emergency?