A.S.C - HSE Office Report

• Year (e.g. P21)

• Office

  Exemplar House

• Conducted on

  Date

• Prepared by (Initials)

General Information

• Use

• Number of Employees

• Working environment?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

Walking Surfaces

• Walkways free of obstacles?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Floor coverings in good condition?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

Office Equipment

• In good condition?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Suitable for the working environment?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

Indoor Air Quality

• Ventilation systems regularly inspected, tested and maintained?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Air inlets and exhaust free of accumulation of dust and mould?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

Housekeeping

• Good housekeeping regime in place?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Equipment and material stored safely?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• The waste container is sufficient and there is no overflow?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

Training

• Employees aware of company policies and procedures?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Employees provided with an induction when the start work?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Staff training current?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

Worker Awareness

• Staff know how to report an accident or a hazard?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Workers know the evacuation procedure?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Workers know whom to contact for first aid assistance?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Workers know the location of fire extinguishers and how to use them?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

Fire Prevention

• Extinguishers available & accessible?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Extinguishers inspected within the last 12 months?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Fire exits clear?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Fire doors closed?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Fire exits lit?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

Electrical Safety

• Periodical inspection in date?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Portable appliance check in date?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

First Aid

• First aid kits available?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• First aid kits checked monthly?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Certificates of First Aiders posted and current?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Accident reporting and investigation?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

Ergonomics

• Have users undertaken a recent (within the last 3 years) DSE assessment

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

Security

• Is access into the office secured against unauthorised persons?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

Parking Lot

• Is the parking lot clear of debris?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Are there no potholes that may result in a trip hazard?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

• Are sidewalks, ramps and walking surfaces in good repair?

  Compliant

  Opportunity for improvement

  Not compliant

  Other responsibility

  N/A or N/C

Completion

• Any other observations or recommendations

• Full Name and Signature of the Inspector

  Sign