Burnley College Health and Safety Appraisal - Rev A

• Employer Name

• Division

  Select Engineering Construction Foundation & Community Studies Creative Industries and Computing Health and Social Development Sports Business

  • Engineering
  • Construction
  • Foundation & Community Studies
  • Creative Industries and Computing
  • Health and Social Development
  • Sports
  • Business

• Conducted on

  Date

• Carried out by

Employer Details

• Employee Address
  Address

• E-mail address

• Main Contact and Contact Number

• Number of employees (approx).

• Nature of Business and type of work being undertaken

• Person responsible for Health and Safety

• Have you ever had any enforcement action?

  Yes

  No

  N/A

• Type of Enforcement Action

  PROSECUTION

  PROHIBITION NOTICE

  IMPROVEMENT NOTICE

  OTHER

• Details of Enforcement Action

• Date of Appraisal

  Date

• Evidence of Employers Liability Insurance

  Media

• ELI Review Date

  Date

• Public Liability Insurance Viewed

  Yes

  No

  N/A

Risk Rating & Frequency

• High Risk - 12 Monthly - Construction, Engineering, Foundation & Community Studies
  Medium Risk - 18 Monthly - Creative Industries & Computing, Health & Social Development, Sports
  Low Risk - 24 Monthly - Business, Computing

• Risk Rating

  High Risk

  Medium Risk

  Low Risk

• Next appraisal due

  Date

• Areas Appraised

  Select Machine Shop Warehouse Office Workshop Other

  • Machine Shop
  • Warehouse
  • Office
  • Workshop
  • Other

• Other area/s

Health and Safety Policy

• If 5 or more employees, a written Health and Safety Policy should be available

• Has the employer a written Health and Safety Policy

  Yes

  No

  N/A

• How is the policy communicated

  Employee Handbook

  Displayed on the Noticeboard

  Other

• Other

• How often is the Health and Safety Policy Reviewed?

  Annually

  Other

• Frequency

Risk Assessments and Control Measures

• If 5 or more employees, the risk assessments should be written.

• Has the employer written Risk Assessments?

  Yes

  No

  N/A

• Have the following subjects been risk assessed.

• Fire

  Yes

  No

  N/A

• Workplace

  Yes

  No

  N/A

• C.O.S.H.H. - Control of Substances Hazardous to Health

  Yes

  No

  N/A

• P.U.W.E.R. - Provision and Use of Work Equipment Regulations

  Yes

  No

  N/A

• Manual Handling

  Yes

  No

  N/A

• Asbestos

  Yes

  No

  N/A

• Working at Height

  Yes

  No

  N/A

• Young Persons incl. special needs, disability, medical condition.

  Yes

  No

  N/A

• Examples of good control measures for young people:

• Have the young person (not reached their 18th birthday) and the supervisor been informed of the risk assessments?

  Yes

  No

  N/A

• Comments

Learner Duties

• Please give a brief summary of what duties the learner will be undertaking as part of their employment or work placement.

Accidents, Incidents and First Aid

• What first aid equipment do you have.

  Select First Aid Box Defibrillator Other

  • First Aid Box
  • Defibrillator
  • Other

• Other:

• How many first aiders do you have?

• Where is the first aid box kept

• Does the employer understand their responsibility for accident / disease / dangerous occurrence. (RIDDOR form F2508) and inform Burnley College if the reportable incident is an apprentice / student.

  Yes

  No

  N/A

• HSE website: www.hse.gov.uk/riddor/index.htm

• Who is responsible for reporting Accidents / diseases / dangerous occurrences to HSE, EHO & Burnley College?

• Where is the accident book kept?

Information, Training, Instruction and Communication.

• How is Health and Safety Communicated?

  Select Verbally Tool Box Talks (Safety Awareness Talks) Committee Meetings Other

  • Verbally
  • Tool Box Talks (Safety Awareness Talks)
  • Committee Meetings
  • Other

• Other:

• Does the company have their own training plan, programmes, schedules

  Yes

  No

  N/A

• Does the employer provide an induction and on-going information, instruction and training for the young person

  Yes

  No

  N/A

• Examples:

• Comments

Supervision

• Name of Supervisor / Trainer

• Experience and Qualifications

• Any health and safety qualifications?

  Yes

  No

  N/A

• Comments

• Are there any more supervisors / trainers?

  Yes

  No

  N/A

• Name of Supervisor / Trainer

• Experience and Qualifications

• Any health and safety qualifications?

  Yes

  No

  N/A

• Comments

• Are there any more supervisors / trainers?

  Yes

  No

  N/A

• Name of Supervisor / Trainer

• Experience and Qualifications

• Any health and safety qualifications?

  Yes

  No

  N/A

• Comments

Personal Protective Equipment

• Ear Protection

  Yes

  No

  N/A

• Areas of mandatory use

• Protective Footwear

  Yes

  No

  N/A

• Areas of mandatory use

• Overalls

  Yes

  No

  N/A

• Areas of mandatory use

• Head Protection

  Yes

  No

  N/A

• Areas of mandatory use

• Gloves

  Yes

  No

  N/A

• Areas of mandatory use

• Respiratory / Dust Masks

  Yes

  No

  N/A

• Areas of mandatory use

• Other

  Yes

  No

  N/A

• Areas of mandatory use

• Eye Protection

  Yes

  No

  N/A

• Areas of mandatory use

Work Equipment and Machinery

• Is your work equipment fit for purpose and up to the required safety standard?<br>

  Yes

  No

  N/A

• Comments

• Is the equipment properly maintained?<br>

  Yes

  No

  N/A

• Comments

• Are all guards suitable and in good condition?

  Yes

  No

  N/A

• Comments

• Do you have manufactures information for your equipment readily available?<br>

  Yes

  No

  N/A

• Comments

• When was the last portable appliance testing carried out?

  Date

• Is this date acceptable?

  Yes

  No

  N/A

• Comments

• Are there any areas / activities the learner will be prohibited from entering or doing?

  Yes

  No

  N/A

• Comments

• Does the company have any unguarded / exposed moving parts on machinery / equipment that may cause entanglement, abrasion, shearing, cutting, puncturing, ejection etc. <br>

  Yes

  No

  N/A

• The learner must be prohibited from operating this equipment until adequately guarded.

• Comments

• Is the fixed wiring of electrical appliances inspected regularly (machinery, lighting etc.)<br>

  Yes

  No

  N/A

• Comments

• Is the gas supply regularly inspected?<br>

  Yes

  No

  N/A

• Comments

Prohibitions

• Working at Height

  Select Outside of learner's job role Inadequate Guarding Inadequate Safe Systems e.g. lack of supervision, no P.P.E. Risk of over exposure to Hazardous Substaces

  • Outside of learner's job role
  • Inadequate Guarding
  • Inadequate Safe Systems e.g. lack of supervision, no P.P.E.
  • Risk of over exposure to Hazardous Substaces

• Working at Ladders

  Select Outside of learner's job role Inadequate Guarding Inadequate Safe Systems e.g. lack of supervision, no P.P.E. Risk of over exposure to Hazardous Substaces

  • Outside of learner's job role
  • Inadequate Guarding
  • Inadequate Safe Systems e.g. lack of supervision, no P.P.E.
  • Risk of over exposure to Hazardous Substaces

• Roof work and work on fragile surfaces

  Select Outside of learner's job role Inadequate Guarding Inadequate Safe Systems e.g. lack of supervision, no P.P.E. Risk of over exposure to Hazardous Substaces

  • Outside of learner's job role
  • Inadequate Guarding
  • Inadequate Safe Systems e.g. lack of supervision, no P.P.E.
  • Risk of over exposure to Hazardous Substaces

• Driving any vehicle / plant / machinery

  Select Outside of learner's job role Inadequate Guarding Inadequate Safe Systems e.g. lack of supervision, no P.P.E. Risk of over exposure to Hazardous Substaces

  • Outside of learner's job role
  • Inadequate Guarding
  • Inadequate Safe Systems e.g. lack of supervision, no P.P.E.
  • Risk of over exposure to Hazardous Substaces

• Use of Lifting Equipment e.g. cranes

  Select Outside of learner's job role Inadequate Guarding Inadequate Safe Systems e.g. lack of supervision, no P.P.E. Risk of over exposure to Hazardous Substaces

  • Outside of learner's job role
  • Inadequate Guarding
  • Inadequate Safe Systems e.g. lack of supervision, no P.P.E.
  • Risk of over exposure to Hazardous Substaces

• Demolition / Dismantling

  Select Outside of learner's job role Inadequate Guarding Inadequate Safe Systems e.g. lack of supervision, no P.P.E. Risk of over exposure to Hazardous Substaces

  • Outside of learner's job role
  • Inadequate Guarding
  • Inadequate Safe Systems e.g. lack of supervision, no P.P.E.
  • Risk of over exposure to Hazardous Substaces

• Excavations or work in trenches or underground

  Select Outside of learner's job role Inadequate Guarding Inadequate Safe Systems e.g. lack of supervision, no P.P.E. Risk of over exposure to Hazardous Substaces

  • Outside of learner's job role
  • Inadequate Guarding
  • Inadequate Safe Systems e.g. lack of supervision, no P.P.E.
  • Risk of over exposure to Hazardous Substaces

• Working on or near asbestos containing materials

  Select Outside of learner's job role Inadequate Guarding Inadequate Safe Systems e.g. lack of supervision, no P.P.E. Risk of over exposure to Hazardous Substaces

  • Outside of learner's job role
  • Inadequate Guarding
  • Inadequate Safe Systems e.g. lack of supervision, no P.P.E.
  • Risk of over exposure to Hazardous Substaces

• Use of vibrating equipment e.g. angle grinders, power chisels/hammers, road breaking drills

  Select Outside of learner's job role Inadequate Guarding Inadequate Safe Systems e.g. lack of supervision, no P.P.E. Risk of over exposure to Hazardous Substaces

  • Outside of learner's job role
  • Inadequate Guarding
  • Inadequate Safe Systems e.g. lack of supervision, no P.P.E.
  • Risk of over exposure to Hazardous Substaces

• Working on live electricity or gas

  Select Outside of learner's job role Inadequate Guarding Inadequate Safe Systems e.g. lack of supervision, no P.P.E. Risk of over exposure to Hazardous Substaces

  • Outside of learner's job role
  • Inadequate Guarding
  • Inadequate Safe Systems e.g. lack of supervision, no P.P.E.
  • Risk of over exposure to Hazardous Substaces

• Working in confined spaces

  Select Outside of learner's job role Inadequate Guarding Inadequate Safe Systems e.g. lack of supervision, no P.P.E. Risk of over exposure to Hazardous Substaces

  • Outside of learner's job role
  • Inadequate Guarding
  • Inadequate Safe Systems e.g. lack of supervision, no P.P.E.
  • Risk of over exposure to Hazardous Substaces

• Comments

Fire and Emergencies.

• Does the employer have:

• Fire Exits (clear and well signed) unobstructed and unlocked

  Yes

  No

  N/A

• Means of fire fighting, extinguishers etc.

  Yes

  No

  N/A

• Date extinguishers serviced (must be within the last 12 months)

  Date

• Is the service date acceptable

  Yes

  No

  N/A

• Add service extinguishers to the action plan.

• Means of raising the alarm?

  Yes

  No

  N/A

• Raising the alarm

  Select Break / Push Glass Air horn Verbal Shout Other

  • Break / Push Glass
  • Air horn
  • Verbal Shout
  • Other

• Comments

• Emergency Evacuation Drills

  Yes

  No

  N/A

• Fire Alarm Tests

  Yes

  No

  N/A

• Emergency Evacuation Procedures

  Yes

  No

  N/A

• Proper storage facilities for flammable liquids / gasses

  Yes

  No

  N/A

• Comments

Working Environment

• Is the working environment suitable?

• Housekeeping adequate?

  Safe

  At Risk

  N/A

• Building structure adequate?

  Safe

  At Risk

  N/A

• Heating and ventilation adequate?

  Yes

  No

  N/A

• Traffic routes suitable?

  Yes

  No

  N/A

• Do you carry out inspection tours to check on continuing compliance?

  Yes

  No

  N/A

• Frequency:

• Comments

Hazardous Substances

• Will the learner be exposed to any substances that are hazardous to health i.e. chemicals, fumes, adhesives, dusts, lacquers, asbestos, lead, radiation etc.

  Yes

  No

  N/A

• Name of hazardous substance

• Hazard

  Select Irritant Harmful Biological Toxic Corrosive Carciogenic Flammable

  • Irritant
  • Harmful
  • Biological
  • Toxic
  • Corrosive
  • Carciogenic
  • Flammable

• Control Measure/s

  Select Extraction Restricted Areas Enclosure Training PPE Other

  • Extraction
  • Restricted Areas
  • Enclosure
  • Training
  • PPE
  • Other

• Is the learner exposed to any further hazardous substances?

  Yes

  No

  N/A

• Name of hazardous substance

• Hazard

  Select Irritant Harmful Biological Toxic Corrosive Carciogenic Flammable

  • Irritant
  • Harmful
  • Biological
  • Toxic
  • Corrosive
  • Carciogenic
  • Flammable

• Control Measure/s

  Select Extraction Restricted Areas Enclosure Training PPE Other

  • Extraction
  • Restricted Areas
  • Enclosure
  • Training
  • PPE
  • Other

• Is the learner exposed to any further hazardous substances?

  Yes

  No

  N/A

• Name of hazardous substance

• Hazard

  Select Irritant Harmful Biological Toxic Corrosive Carciogenic Flammable

  • Irritant
  • Harmful
  • Biological
  • Toxic
  • Corrosive
  • Carciogenic
  • Flammable

• Control Measure/s

  Select Extraction Restricted Areas Enclosure Training PPE Other

  • Extraction
  • Restricted Areas
  • Enclosure
  • Training
  • PPE
  • Other

• Is the learner exposed to any further hazardous substances?

  Yes

  No

  N/A

• Name of hazardous substance

• Hazard

  Select Irritant Harmful Biological Toxic Corrosive Carciogenic Flammable

  • Irritant
  • Harmful
  • Biological
  • Toxic
  • Corrosive
  • Carciogenic
  • Flammable

• Control Measure/s

  Select Extraction Restricted Areas Enclosure Training PPE Other

  • Extraction
  • Restricted Areas
  • Enclosure
  • Training
  • PPE
  • Other

• Is the learner exposed to any further hazardous substances?

  Yes

  No

  N/A

• Name of hazardous substance

• Hazard

  Select Irritant Harmful Biological Toxic Corrosive Carciogenic Flammable

  • Irritant
  • Harmful
  • Biological
  • Toxic
  • Corrosive
  • Carciogenic
  • Flammable

• Control Measure/s

  Select Extraction Restricted Areas Enclosure Training PPE Other

  • Extraction
  • Restricted Areas
  • Enclosure
  • Training
  • PPE
  • Other

• Is the learner exposed to any further hazardous substances?l

  Yes

  No

  N/A

• Name of hazardous substance

• Hazard

  Select Irritant Harmful Biological Toxic Corrosive Carciogenic Flammable

  • Irritant
  • Harmful
  • Biological
  • Toxic
  • Corrosive
  • Carciogenic
  • Flammable

• Control Measure/s

  Select Extraction Restricted Areas Enclosure Training PPE Other

  • Extraction
  • Restricted Areas
  • Enclosure
  • Training
  • PPE
  • Other

• Biological hazards e.g. micro-organisms, fungi, bacteria and parasites possibly from contact with animals

• Comments

General Health and Safety Management

• Where do you get your health and safety information and advice from?

• For further health and safety information. Please see www.hse.gov.uk/pubns/indg449.htm

• Are the necessary health and safety signs in position and clearly identified?

  Yes

  No

  N/A

• Does the employer display a copy of the Health and Safety Law Poster

  Yes

  No

  N/A

• Does the employer deliver lifting / handling training?

  Yes

  No

  N/A

Signs

• Prohibition Signs (Red circular with a bar across)

  Yes

  No

  N/A

• Examples

• Warning Signs (Yellow triangle)

  Yes

  No

  N/A

• Examples

• Safe Condition Signs (Green square / Rectangle)

  Yes

  No

  N/A

• Examples

• Mandatory Signs (Blue Circular)

  Yes

  No

  N/A

• Examples

Amenity & Welfare

• Toilets (clean)

  Yes

  No

  N/A

• Washbasins

  Yes

  No

  N/A

• Plumbed in (warm) / cold water supplies

  Yes

  No

  N/A

• Soap / cleansers

  Yes

  No

  N/A

• Clean drinking water

  Yes

  No

  N/A

• Eating / drinking areas (clean)

  Yes

  No

  N/A

• Towels / hand drier

  Yes

  No

  N/A

• Heating

  Yes

  No

  N/A

Safeguarding

• Does the employer have policies / procedures for safeguarding of young people / vulnerable adults? (This includes abuse, neglect and involvement in extremism).

  Yes

  No

  N/A

• Inform the apprentice / student that there is assistance at the college. Refer to the college policy. www.burnley.ac.uk

• Who is responsible for safeguarding?

• What are the arrangements for safe guarding issues?

Recommendations Arising from the Appraisal

• Is there evidence of in date Employers Liability Insurance (ELI) ?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Add drawing

  Drawing

• Closed out date

  Date

• Is there evidence of in date Public Liability Insurance (PLI) ?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Is the Health and Safety policy compiled / reviewed?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Are risk assessments compiled / Reviewed (e.g. Young Persons, Fire)?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Are fire exits clear?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Are fire exit signs displayed?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Are fire extinguishers provided / serviced?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Are emergency evacuations practiced and recorded?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Is the fire alarm regularly tested and recorded?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Are emergency evacuation procedures displayed?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Are there suitable storage facilities for flammable gases / liquids?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Is there evidence of an accident book?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Is there evidence of a Health and Safety Law poster?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Is there a suitable first aid kit?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Is there a suitable amount of trained first aiders?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Does the company provide mechanical aids for manual handling?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Is there a sufficient means of providing heating?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Is the lighting suitable?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Are there defined gangways?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Is there a regular cleaning of waste?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Are there defined spillage procedures?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Is there a safe means of access to racking?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Is there a suitable system to segregate pedestrians fro moving vehicles?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Is fixed wiring of electrical systems inspected and tested?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Are portable appliance suitably tested (PAT testing)?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Is the gas system serviced?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Is the guarding / braking of machines suitable?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Are there suitable safeguarding procedures / policies?

  Yes

  No

  N/A

• Action to be closed out by Whom,

• Action to be closed out by when?

  Date

• Closed out date

  Date

• Others / Comments

• Yes

  No

  N/A

Sign Off

• Employer Signature

  Sign

• Job Title

• Burnley College Signature

  Sign

• e-mail to the employer and m.leatherbarrow@burnley.ac.uk