1. THE CLIENT (HOST EMPLOYER)

  • 1.1 Stuctured approach to managing safety is there a system for managing safety?

  • 1.2 Is there a documented system for managing safety?

  • 1.3 Historical WHS performance what is your WorkCover number?

  • 1.4 What is your industry premium rate?

  • 1.5 What is your premium rate?

  • 1.6 Is your premium rating greater than your industry premium? (This can indicate poor workplace health and safety management)

  • 1.7 Organisational size and structure of workforce - Do you know how many full-time workers you have?

  • 1.8 Do you know how many casual and labour hire workers you have?

  • 1.9 Is there a much greater number of casual and labour hire workers to full-time workers?

  • 1.10 Historical claims performance do you know how many injuries you have had in the past year?

  • 1.11 will labour hire workers be working in these areas where injuries were mostly sustained?

2. THE WORK

  • 2.1 Job title:

  • 2.2 Summary of tasks:

  • 2.3 Plant and equipment to be used:

  • 2.4 Subatances and materials to bo used:

  • 2.5 Hours of work:

  • 2.6 Intended duration of contract:

  • 2.7 Supervisor (name, position and contact details):

  • 2.8 Level of supervision to be provided (tick):

  • 2.9 Training provided before commencing work (tick):

  • 2.10 Is personal protective equipment required? (tick):

3. THE WORKER

  • 3.1 Qualifications the worker should possess:

  • 3.2 Experience the worker should possess:

  • 3.3 Other selection criteria (medical/literacy/numeracy):

4.THE WORK ENVIRONMENT

  • 4.1 Physical location of work - address of workplace:

  • 4.2 Physical location of work (e.g. workshop, plant number etc.)

  • 4.3 To whom are safety issues to be reported? (name, role and contact details):

  • 4.4 How are safety issues to be reported? (tick):

  • 4.5 Is there a safety coordinator? (tick):

  • 4.6 Is the safety coordinator? (tick):

5. HAZARDS IN THE WORKPLACE

  • 5.1 Loud noise

  • 5.2 Lifting

  • 5.3 Electrical

  • 5.4 Chemicals

  • 5.5 People and vehicles in same area

  • 5.6 Falling objects

  • 5.7 Dangerous machinery

  • 5.8 Vehicles/plant

  • 5.9 Unguarded equipment

  • 5.10 Heavy tools

  • 5.11 Stretching or reaching

  • 5.12 Slippery or cluttered floors

  • 5.13 Hazardous substances

  • 5.14 Manual tasks

  • 5.15 Other

WHO COMPLETED THE WORKPLACE VISIT AND VALIDATED THE INFORMATION PROVIDED BY THE CLIENT?

  • Name:

  • Add signature

  • Date:

  • Proceed to placement (tick):

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