Alternative Provider Assessment Form

• Audit Title

• Document No.

• Organisation Name

• Visited By

• Visit Date

  Date

• Date of Next Assessment

  Date
• Location
  Address

• Nature of activity at location

  Select Agriculture Horticulture Forestry Fishery Animal Work Construction Building maintenance Engineering Mechanical Scientific Technical Manufacturing Art, Craft and Design Retail Financial Business Personal Service Hotel Catering Leisure Services Community Care Health Education / Training Uniformed Services

  • Agriculture
  • Horticulture
  • Forestry
  • Fishery
  • Animal Work
  • Construction
  • Building maintenance
  • Engineering
  • Mechanical
  • Scientific
  • Technical
  • Manufacturing
  • Art, Craft and Design
  • Retail
  • Financial
  • Business
  • Personal Service
  • Hotel
  • Catering
  • Leisure Services
  • Community Care
  • Health
  • Education / Training
  • Uniformed Services

• Recommendation

  Suitable

  Suitable with Conditional Action Plan

  Unsuitable

• Overall Risk Category

  High

  Medium

  Low

• Type

  Initial Assessment

  Re-assessment

  Extended

  Block

• Other

• CRB Recommendation

  Yes

  No

Action Point 1

• Ref. No.

• Action required

• Related image

  Media

• Target date

  Date

• How was completed action verified?

  Verbal

  Letter

  Email

  FAX

  Visit

• Date of confirmation

  Date

Action Point 2

• Ref. No.

• Action required

• Related image

  Media

• Target date

  Date

• How was completed action verified?

  Verbal

  Letter

  Email

  FAX

  Visit

• Date of confirmation

  Date

Action Point 3

• Ref. No.

• Action required

• Related image

  Media

• Target date

  Date

• How was completed action verified?

  Verbal

  Letter

  Email

  FAX

  Visit

• Date of confirmation

  Date

Action Point 4

• Ref. No.

• Action required

• Related image

  Media

• Target date

  Date

• How was completed action verified?

  Verbal

  Letter

  Email

  FAX

  Visit

• Date of confirmation

  Date

Action Point 5

• Ref. No.

• Action required

• Related image

  Media

• Target date

  Date

• How was completed action verified?

  Verbal

  Letter

  Email

  FAX

  Visit

• Date of confirmation

  Date

Action Point 6

• Ref. No.

• Action required

• Related image

  Media

• Target date

  Date

• How was completed action verified?

  Verbal

  Letter

  Email

  FAX

  Visit

• Date of confirmation

  Date

• Contact Name

• Street Address

• District

• Town

• County

• Postcode

• Health and Safety Contact

• Tel. No.

• Email address

• Website address

• Size of organisation

  4 or less

  5 to 24

  25 to 49

  50 to 199

  200+

• Image (if appropriate)

  Media

• 1.1 Is the employers' liability insurance policy current and is other insurance cover in place as appropriate to the business' undertaking (e.g. public liability and vehicle insurance)?

Employers liability

• Insurance company

• Policy number

• Liability level (£M)

• Expiry date

  Date

Public liability

• Insurance company

• Policy number

• Liability level (£M)

• Expiry date

  Date

• 1.3 Has the organisation registered with the appropriate enforcing authority for health and safety (OSR1 / F9 Form)?

  Yes

  No

• Comments / Actions

• 1.4 Does the organisation display appropriate health and safety signs and notices?

  Yes

  No

• Comments / Actions

• 1.5 Does the organisation keep up to date with the requirements of health and safety legislation? How does the organisation access Health and Safety Advice?

  Yes

  No

• Comments / Actions

• 1.6 Has the organisation received any prosecutions, prohibitions, or Improvement Notices served by the Health and Safety Executive, Environmental Health Officer or Fire Service in respect of any Health and Safety or fire legislation? Do you have any investigations pending? (If yes to any of the above, give details)

  Yes

  No

• Comments / Actions

• 1.7 Does the Organisation have a Safeguarding Policy? (Copy obtained)

  Yes

  No

• Comments / Actions

• 1.8 Child Protection: Have child protection issues been considered and appropriate actions implemented to safeguard young people? (Staff CRB checked)

  Yes

  No

• Comments / Actions

• 1.9 In relation to CRB checks: if disclosures are evidenced, how are they assessed and managed by the provider?

• Comments / Actions

• 2.1 Is there a current health and safety policy in place? Is it dated and signed?

  Yes

  No

• Comments / Actions

• 2.2 Does the policy include arrangements for the health and safety of young people?

  Yes

  No

• Comments / Actions

• 3.1 Have risk assessments been carried out to identify significant risks and put adequate risk control measures in place? (Copy obtained)

  Yes

  No

• Comments / Actions

• 4.1 Have adequate arrangements for first aid equipment and/or facilities been made?

  Yes

  No

• Comments / Actions

• 4.2 Have adequate arrangements for first aiders and/or appointed persons been made?

  Yes

  No

• Comments / Actions

• Who is responsible for first aid?

• To whom should accidents be reported?

• 4.3 Are accidents and first aid treatment appropriately recorded?

  Yes

  No

• Comments / Actions

• 4.4 Are schools/parents informed of any accidents? If so, how?

  Yes

  No

• Comments / Actions

• 4.5 Are or will all RIDDOR reportable events be reported to the enforcing authority and will the Organisation investigate and take suitable remedial action?

  Yes

  No

• Comments / Actions

• 5.1 Do arrangements for the initial induction and training of young people appear to be adequate? What arrangements are in place?

  Yes

  No

• Comments / Actions

• 5.2 Who is the named person in the organisation responsible for the pupils?

• 5.3 Do arrangements for the supervision of students appear to be adequate (including lunch breaks)? What arrangements are in place?

  Yes

  No

• Comments / Actions

• 5.4 Do pupils go off site for lunch? If so, how are the school/parents made aware of this?

  Yes

  No

• Comments / Actions

• 5.5 Do you have arrangements for monitoring attendance and how do you report this to schools?

  Yes

  No

• Comments / Actions

• 5.6 Do teaching staff visit you to check on the progress of students? If so, how often?

  Yes

  No

• Comments / Actions

• 5.7 Is ongoing health and safety information, instruction and training given to all employees? Recent example?

  Yes

  No

• Comments / Actions

• 6.1 Is machinery and work equipment installed and operating at the appropriate standards (e.g. guards, emergency stop buttons, anti-glare screens etc.)?

  Yes

  No

• Comment / Action

• 6.2 Is machinery and work equipment adequately maintained?

  Yes

  No

• Comment / Action

• 6.3 Are safe electrical systems and equipment provided and maintained?

  Yes

  No

• Comment / Action

• 7.1 Is PPE/C provided, free of charge, to learners as determined through risk assessment?

  Yes

  No

• Comments / Actions

• 7.2 What arrangements are in place to ensure that PPE/C is used properly and effectively?

  Yes

  No

• Comments / Actions

• 8.1 Has a suitable and sufficient fire risk assessment been carried out?

  Yes

  No

• Comments / Actions

• 8.2 Are adequate arrangements in place for dealing with fires and other emergencies?

  Yes

  No

• Comments / Actions

• 9.1 Are premises and the working environment safe and healthy?

  Yes

  No

• Comments / Actions

• 9.2 Are adequate welfare facilities and arrangements provided?

  Yes

  No

• Comments / Actions

• 9.3 Are measures in place to ensure that the risks presented by workplace traffic are properly controlled?

  Yes

  No

• Comments / Actions

• 9.4 Do pupils go out on visits to other sites as part of the programme?

  Yes

  No

• Comments / Actions

• 9.5 If so, are schools and parents informed and how is that undertaken? Also, what are staffing ratios?

  Yes

  No

• Comments / Actions

• 9.6 If learning takes place at other locations e.g. work experience, work placements etc. do arrangements include assessing Health and Safety and Safeguarding suitability prior to the learning taking place? (Sample copies of H&S audits, Risk Assessments required)

  Yes

  No

• Comments / Actions

• 9.7 Do staff who conduct Health and Safety visits/assessments hold appropriate qualifications? If so, what are they?

  Yes

  No

• Comments / Actions

• 9.8 How is information passed back to schools / parents about the risks attached to going on a placement?

  Yes

  No

• Comments / Actions

• 9.9 What are the arrangements for monitoring attendance on work placements and how are these reported back to schools?

  Yes

  No

• Comments / Actions

• I confirm that the information recorded herein is true and that:
  
  - opportunities will be open equally to learners regardless of gender, race, disability, cultural and religious beliefs.
  
  - learners will carry out meaningful work, planned and supervised by competent person(s) at all times, and the provider will take responsibility for the health, safety and welfare of learners during the period of engagement / provision.
  
  - the provider will comply with all relevant current health and safety legislation and official guidance and is registered with the appropriate enforcement authority.
  
  - learners will not do work prohibited by law - for example operate dangerous machinery, carry out manual handling tasks or handle dangerous substances that may endanger their health or safety.
  
  - at the commencement of their provision learners will be given a health and safety induction which will include hazards, control measures, fire, emergencies, first aid, accident reporting and security and welfare arrangements.
  
  - learners will be briefed on and have access to whatever first aid facilities and arrangements are provided for employees.
  the organisation will provide and maintain suitable & appropriate equipment and machinery which is safe and without risk to the health of the learner.
  
  - learners will be given appropriate instruction before and close supervision while operating machinery or equipment or handling substances.
  
  - learners will be provided with and instructed on the correct use of appropriate personal protective clothing / equipment and its use will be enforced.
  
  - learners will be covered, for the period of the provision by the appropriate insurance and insurers suitably notified. Where appropriate learners are similarly covered by any relevant Motor Vehicle insurance.
  
  - the provider complies with RIDDOR 1995 and in the case of any accident, incident, sickness, or behaviour considered unacceptable by the placement the learners’s school or relevant authority will be informed, without delay, by telephone.
  the provider will allow access for Local Authority staff or their representative to carry out accident investigation or check agreement compliance.
  
  - the provider will take into account any information, supplied by parents / guardians or school relating to the learners’ specific support needs so as not to create additional risks either to the learner or staff.
  
  - the provider will ensue that learners are safe from bullying and harassment and that adequate Child Protection / Safeguarding measures are in place.

• Signature

  Sign

• Position in company

• Date

  Date

• EBP Assessor

  Sign

• Does there appear to be a High, Medium, or Low level of risk associated with the placement occupational context?

  High

  Medium

  Low

• Does there appear to be a High, Medium, or Low level of risk associated with the Employer's compliance and understanding of Health and Safety Issues?

  High

  Medium

  Low