Assessment of a Customer Premises Delivery Point - duplicate

• Name

• Site / SAP Number

• Date

  Date

• Prepared by

• Location
  Address

• INSTRUCTIONS:
  -------------------------------------
  1. Answer the applicable questions below.
  2. Add photos and notes by clicking on the paperclip icon.
  3. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
  4. Complete audit by providing digital signature.
  5. Share your report by exporting as PDF, Word, Excel or Web Link.

General Information

• Reversing required

  Yes

  No

• Distance in metres

Vehicle Access to Point of Delivery (POD)

Parking

• Parking outside POD possible

  ✔

  ✖

  N/A

• Parking available within 20m

  ✔

  ✖

  N/A

• Parking available within 50m

  ✔

  ✖

  N/A

• Parking available within 100m

  ✔

  ✖

  N/A

Pedestrians

• Children/pedestrians present at POD?

  ✔

  ✖

  N/A

• Children/pedestrians present in reversing area?

  ✔

  ✖

  N/A

• Blind bends on reversing route?

  ✔

  ✖

  N/A

• Does the route cross school play areas?

  ✔

  ✖

  N/A

Local Arrangements

• Do you need to book in?

  ✔

  ✖

  N/A

• Are there time restrictions?

  ✔

  ✖

  N/A

• Is there someone to act as a guide?

  ✔

  ✖

  N/A

Documents

• Is there a risk assessment provided by the customer for deliveries?

  ✔

  ✖

  N/A

• Is there a written instruction for agency drivers?

  ✔

  ✖

  N/A

Delivery Route - Vehicle to Point of Delivery (POD)

• Distance to Carry (without a cage or barrow)

  Less than 10m

  Between 10 and 20m

  More than 20 m

• External Steps

  ✔

  ✖

  N/A

• Is the route steep or in poor condition?

  Yes

  No

• Number of steps

• Internal Stairs

  ✔

  ✖

  N/A

• Is the route steep or in poor condition?

  Yes

  No

• Number of steps

• Slopes

  ✔

  ✖

  N/A

• Is the slope steep?

  Yes

  No

• Is the slope in poor condition?

  Yes

  No

• Doors

  1 doorway

  2 - 3 doorways

  More than 3

• Please specify

• Other hazards

  Low ceiling

  Trip hazards

  Slippery floor surface

• Lighting on the route

  Good

  Fair

  Poor

• Number of trips (on average)

  1-5

  6-10

  More than 10

• Please specify

Point of Delivery

• Does delivering the load involve any of the hazards listed below?

• Bending over a chest freezer

  ✔

  ✖

  N/A

• Walking through a crowded kitchen/room

  ✔

  ✖

  N/A

• Reaching up to a high shelf

  ✔

  ✖

  N/A

• Poor drains or floor gullies

  ✔

  ✖

  N/A

• Over-reaching

  ✔

  ✖

  N/A

• Extremes of temperature

  ✔

  ✖

  N/A

Completion

• Comments

• Driver Name and Signature

  Sign

• Review Details:
  To be reviewed annually.
  If there are any changes to the original assessment a new assessment must be completed. If there are no changes to the original assessment please complete the below;

• Signature of Distribution Manager or nominated alternative: Click "Add Signature"

Signature

• Name and Signature

  Sign