Universal 5S Assessment Form (Shop/Office/Common Areas)

Date:

Assessor:
Item
Sort

Work Area:
Criteria

Furniture (bench/table, desk, chairs, cabinets, etc.)

Machinery/Equipment/Tools/Storage Areas
Supplies/Safety Devices/Containers(trash/recycle)
Documents/Boards
Work in Process
Opportunities for Improvement:

Required to perform work/Uncluttered with no unnecessary items

Required to perform work
Required to perform work
Up-to-date and Required to perform work
Length of time the inventory/material is in queue in the area

Straighten

Furniture (bench/table, desk, chairs, cabinets, etc.)

Machinery/Equipment/Tools/Storage Areas
Supplies/Safety Devices/Containers(trash/recycle)
Documents/Boards
Floors/Aisles
Opportunities for Improvement:

Labeled and in place

Labeled/in place/operable
All required devices are in place/labeled/operable
Organized/Up-to-date/labeled/available
Clearly designated/aisles free of obstructions

Shine

Furniture (bench/table, desk, chairs, cabinets,etc.)

Equipment/Tools/Storage Areas/Safety Devices
Containers(trash/recycle)
Cleaning Equipment
Floors/Aisles/Boards/Walls
Opportunities for Improvement:

Cleaned/painted(if needed)/free of clutter

Cleaned/painted(if needed)/free of debris
Cleaned/free of debris, food, and beverage
Cleaned/free of debris
Cleaned/free of debris, food, and beverage spills/painted

Standardize Sort
Straighten
Shine
Documents and Boards
Evaluation Audit
Machinery
Opportunities for Improvement:

The area is re-sorted (unnecessary items are not in the area)

The area is re-straightened (nothing is out of place)
Housekeeping responsibilities are assigned
Responsibility for updating is assigned (everything is up-to-date )
There is a periodic 5S evaluation and review of schedules
Machinery information is current, visible, and checklists are used

Sustain

Everyone is committed to 5S and practices 5S daily

5S metrics are formal, reported at department level, and posted
Is proactive in supporting 5S
5S is part of the process of work itself

Commitment
Metrics
Management
Integration
Opportunities for Improvement:

List "opportunities for improvement" if score is not a (5)

Check off the appropriate box.

0

Poor

Marginal Average

Good

Better

Best

None

Most Not

Some

Most

Mostly All

All

week

day

hours

minutes

All

3+ months month

None

Most Not

Some

Most

Mostly All

Filthy

Dirty

Dusty

Clean

Very clean Like New

Never

Seldom SometimesMost Always

None

Most Not

Some

Most

Daily

Continuous

Mostly All

All

Count each column vertically

Multiply by the column number x 0 =
Add the multiplied columns together

x1=

x2=
Divide by 25 =

x3=

x4=

x5=

Universal 5S Assessment Form (Shop/Office/Common Areas)

Check off the appropriate box.

Universal 5S Assessment Form (Shop/Office/Common Areas)

Date:

Assessor:
Item
Sort

Work Area:
Criteria

Furniture (bench/table, desk, chairs, cabinets, etc.)

Machinery/Equipment/Tools/Storage Areas
Supplies/Safety Devices/Containers(trash/recycle)
Documents/Boards
Work in Process
Opportunities for Improvement:

Required to perform work/Uncluttered with no unnecessary items

Required to perform work
Required to perform work
Up-to-date and Required to perform work
Length of time the inventory/material is in queue in the area

Straighten

Furniture (bench/table, desk, chairs, cabinets, etc.)

Machinery/Equipment/Tools/Storage Areas
Supplies/Safety Devices/Containers(trash/recycle)
Documents/Boards
Floors/Aisles
Opportunities for Improvement:

Labeled and in place

Labeled/in place/operable
All required devices are in place/labeled/operable
Organized/Up-to-date/labeled/available
Clearly designated/aisles free of obstructions

Shine

Furniture (bench/table, desk, chairs, cabinets,etc.)

Equipment/Tools/Storage Areas/Safety Devices
Containers(trash/recycle)
Cleaning Equipment
Floors/Aisles/Boards/Walls
Opportunities for Improvement:

Cleaned/painted(if needed)/free of clutter

Cleaned/painted(if needed)/free of debris
Cleaned/free of debris, food, and beverage
Cleaned/free of debris
Cleaned/free of debris, food, and beverage spills/painted
Clean areas after every shift

Standardize Sort
Straighten
Shine
Documents and Boards
Evaluation Audit
Machinery
Opportunities for Improvement:

The area is re-sorted (unnecessary items are not in the area)

The area is re-straightened (nothing is out of place)
Housekeeping responsibilities are assigned
Responsibility for updating is assigned (everything is up-to-date )
There is a periodic 5S evaluation and review of schedules
Machinery information is current, visible, and checklists are used

Sustain

Everyone is committed to 5S and practices 5S daily

5S metrics are formal, reported at department level, and posted
Is proactive in supporting 5S
5S is part of the process of work itself

Commitment
Metrics
Management
Integration
Opportunities for Improvement:

List "opportunities for improvement" if score is not a (5)

Clean areas after each shift

Count each column vertically

Check off the appropriate box.

0

Poor

Marginal Average

Good

Better

Best

None

Most Not

Some

Most

Mostly All

All

week

day

hours

minutes

All

3+ months month

None

Most Not

Some

Most

Mostly All

Filthy

Dirty

Dusty

Clean

Very clean Like New

Never

Seldom SometimesMost Always

None

Most Not

Some

Multiply by the column number x 0 = 0

Add the multiplied columns together

x1=1

x 2 = 12

Divide by 25 =

Daily

Continuous

Most

Mostly All

All

x 3 = 30
0

x 4 = 20

x5=0

Universal 5S Assessment Form (Shop/Office/Common Areas)

Check off the appropriate box.