1. HSE Appraisal Record february 2017

• company

• Physical

• Desktop

Employer Details

• Company name.

• Workplace address (Including postcode)
  Address

• Nature of business.

• Date.

  Date

• Insurers name:

• Policy number:

• ELI Date

  Date

• ELI

  Media

• how many employees

• Main contact person.

• Phone number.

• Health and safety contact.

• Email address.

• T2000 Area/Dept Appraisal.

• Type of work carried out by the learner at the workplace location.

• CDA/LA Name.

Risk Banding

• Risk Banding

  Select H M L

  • H
  • M
  • L

Authorisation of Placement

• Fully approved.

• Conditionally Approved (Subject to completion of Development Plan).

• Unsatisfactory.

• Audit Title

• HSE Authorising Signature

  Sign

Development Plan

• Development Plan For

• Ref 1. Action required

• By who

• Target date.

  Date

• Completed (signed off)

• Ref 2. Action required

• By who

• Target date.

  Date

• Completed (signed off)

• Ref 3. Action required.

• By who.

• Target date.

  Date

• Completed (signed off).

• Ref 4. Action required.

• By who.

• Target date.

  Date

• Completed (signed off).

• Ref 5. Action required.

• By who.

• Target date.

  Date

• Completed (signed off).

• To the Authorising Officer:
  It is recommended that the above named organisation should be regarded as:-

• Approved.

• Conditionally Approved (Subject to completion of development plan).

• Unsatisfactory.

• As a provider of work experience / on-job training for Training 2000 Ltd.

• HSE Advisor Signature.

  Sign

• Is the organisation accredited to any iso standards ?

  yes

  no

• indicate any standards accredited.

  Select iso 14001 iso 9001 bsohsas18001

  • iso 14001
  • iso 9001
  • bsohsas18001

• Does the employer have access to competent health and safety advice and assistance?

  Yes

  No

  N/A

1. Health and Safety Policy

• A. Is there a clear commitment to health, safety and welfare (written policy statement , mandatory when 5 or more employees?

  Yes

  No

  N/A

• B. are the responsibilities for health and safety clearly stated (recorded when 5 or more employees(.

  Yes

  No

  N/A

• C. Are arrangements for health and safety clearly stated (recorded when 5 or more employees).

  Yes

  No

  N/A

• D. How are commitment, responsibilities and arrangements for health and safety (in 1AM and 1C above) communicated to employees?

• how are commitment responsibilities and arrangements for health and safety communicated?

  Verbally and written?

  Written document only?

  Verbal only?

• Assessment of Standard 1:

  Select Met Part Met Not Met

  • Met
  • Part Met
  • Not Met

2. Risk Assessment and Control

• A. Have risk assessments been carried out on procedures and substances used and significant risks identified?

  Yes

  No

  N/A

• B. have significant findings and details of any groups identified as being especially at risk been recorded (mandatory when 5 or more employees).

  Yes

  No

  N/A

• C. Have control measured been identified and put in place as a result of the risk assessments?

  Yes

  No

  N/A

• D. Will the risk assessments take into account young persons, including giving consideration of their age, inexperience, immaturity and lack of awareness of risk assessments?

  Yes

  No

  N/A

• E. will the assessment take into account any other special needs or circumstances including ant disability and / or medical / health conditions

  Yes

  No

  N/A

• F. Will the employer put in control measures for the learner as a result of the assessment and will they inform the learner and their supervisor?

  Yes

  No

  N/A

• How are the risks and controls identified eplained to employees and others?

  Verbally and written?

  Written document only?

  Verbal only?

• Assessment of Standard 2:

  Select Met Part Met Not Met

  • Met
  • Part Met
  • Not Met

3. Accident, Incidents and First Aid

• A. Have adequate arrangements for first aid materials been made?

  Yes

  No

  N/A

• B. have adequate arrangements for trained first aid persons been made?

  Yes

  No

  N/A

• C. Are accidents and first aid treatment rendered recorded?

  Yes

  No

  N/A

• D. Are or will all legally reportable accidents and incidents be reported and investigated?

  Yes

  No

  N/A

• how are the arrangements for accidents / incidents and first aid communicated to all employees?

  Verbally and written?

  Written document only?

  Verbal only?

• Assessment of Standard 3:

  Select Met Part Met Not Met

  • Met
  • Part Met
  • Not Met

4. Information, Instruction, Training and Supervision

• A. Are employees provided with competent supervision?

  Yes

  No

  N/A

• B. Is initial health and safety information, instruction and training given to all new employees on recruitment?

  Yes

  No

  N/A

• C. Is ongoing health and safety information, instruction and training provided to all employees?

  Yes

  No

  N/A

• D. Is health and safety information, instruction and training recorded?<br>(This is recorded in Training 2000 quality assured Induction Pack)

  Yes

  No

  N/A

• how is the effectiveness of health and safety information and training assessed and is the assessment recorded?

  training records kept

  verified by observation and / or discussion with employee / Training records kept

  No records maintained

• Assessment of Standard 4:

  Select Met Part Met Not Met

  • Met
  • Part Met
  • Not Met

5. Work Equipment and Machinery

• A. Is the correct and equipment provided to the appropriate standards?

  Yes

  No

  N/A

• B. Is the equipment maintained and is it recorded?

  Yes

  No

  N/A

• C. Are guards and control measures in place as determined through risk assessment?

  Yes

  No

  N/A

• D. Are safe electrical systems and equipment provided and maintained (eg PAT testing)?

  Yes

  No

  N/A

• Assessment of Standard 5:

  Select Met Part Met Not Met

  • Met
  • Part Met
  • Not Met

6. Personal Protective Equipment and Clothing

• A. Is PPE provided free of charge to employees as determined through risk assessment (list items)?

  Yes

  No

  N/A

• B. Is training and information on the safe use of PPE/C provided to all employees?

  Yes

  No

  N/A

• C. Is the proper use and storage of PPE/C enforced?

  Yes

  No

  N/A

• D. Is PPE/C maintained and replaced?

  Yes

  No

  N/A

• Assessment of Standard 6:

  Select Met Part Met Not Met

  • Met
  • Part Met
  • Not Met

7. Fire and Emergencies

• A. Is there a risk assessment in place?

  Yes

  No

  N/A

• B. Is there a means of raising the alarm and fire detection in place?

  Yes

  No

  N/A

• C. Are there appropriate meane of fighting fire in place?

  Yes

  No

  N/A

• D. Are there effective means of escape in place including i obstructed routes and exits?

  Yes

  No

  N/A

• E. is there a named person(s) for emergencies?

  Yes

  No

  N/A

• F. Is / are fire fighting equipment, preventative measures and emergency arrangements maintained, including tests and practice drills (Dates required)?.

  Yes

  No

  N/A

• G. Is there a fire log / record book kept?

  Yes

  No

  N/A

• Assessment of Standard 7:

  Select Met Part Met Not Met

  • Met
  • Part Met
  • Not Met

8. Safe and Healthy Working Environment

• A. Are premises (structure, fabric, fixtures and fittings) safe and healthy (suitable, maintained and kept clean)?

  Yes

  No

  N/A

• B. Is the working environment (temperature, lighting, space, ventilation and noise) an appropriate safe and healthy one?

  Yes

  No

  N/A

• C. Are welfare facilities (toilet, washing, drinking, eating and changing) provided as appropriate and maintained?

  Yes

  No

  N/A

• Assessment of Standard 8:

  Select Met Part Met Not Met

  • Met
  • Part Met
  • Not Met

9. General Health and Safety Management

• A. How does the employer consult and communicate with employees and allow them to participate in health and safety?

• B. Does the employer provide medical screening as appropriate and any required medical / health surveillance?

  Yes

  No

  N/A

• c. Does the employer review health and safety annually?

  Yes

  No

  N/A

• d. Does the employer display the necessary signs and notices?

  Yes

  No

  N/A

• e. Is the health and safety law poster displayed?

  Yes

  No

  N/A

• f. Have all the relevant inspections on equipment been carried out in line with legislation?

  Yes

  No

  N/A

• g. How does the employer manage the employees work when it is away from the employers own premises or when employees are placed with another employer / site?

• Assessment of Standard 9:

  Select Met Part Met Not Met

  • Met
  • Part Met
  • Not Met

If an action plan has been identified the action plan is detailed in the development plan section

• Action / Development plan agreed and provided

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Note. All comments raised or areas for improvement should be documented and included on the action plan sheet(s).
  It is the employers responsibility to accept ownership of the action plan to Impliment actions within the times ails advised.

The Employer or their representative: Please sign to agree that this is an accurate record of the assessment.

• This assessment is specific for the safety of the learner and does not endorse a full safe system of work for the employer. It is the Employers responsibility to ensure the Safety of the learner at all times.

• Name and job title:

  Sign

• Assessment completed by:

  Sign

HASP - Learner Specific

• Learners Name:

• Learners Work Location:

• Regular reviews take place with the CDA and learner, which establish the current level of satisfaction, and identify if there are any health and safety non-conformance issues regarding the Employer / Placement.
  
  These reviews are kept within the individual Learner record and any reports of health and safety non-conformance issues are passed to the HSE Department to follow up?

10. Management of Learners / Young Persons Health and Safety

• A. Which items of equipment will the learner / young person be expectedg to use ( when trained)?

• B. Detail any necessary prohibitions and restrictions identified by the risk assessments that apply to the learner / young person?

• C. Does the employer provide competent supervision for learners / young persons and do they have a designated person to take overall responsibility for them?

  Yes

  No

  N/A

• Supervisor(s) name(s)?

• D. Is the employer aware / will the employer make himself / herself aware of the Training 2000 Ltd. Child Protection Policy?

  Yes

  No

  N/A

• E. Has the employer am Equal Opportunities Policy? (If no, refer to the employer sample).

  Yes

  No

  N/A

• F. Are there any materials displayed that may cause offence to employees?

  yes

  no

• G. Has the employer a Bullying and Harassment Policy? ( if no, refer the employer sample)

  Yes

  No

  N/A

• Assessment of Standard 10:

  Select Met Part Met Not Met

  • Met
  • Part Met
  • Not Met

• Note to H & S Advisor:-
  Any actions required resulting from the above assessment must be recorded on the Development Plan

• H&SFM027

• company name