Corona virus COVID-19 Home Office Self Assessment

• Conducted on

  Date

• Prepared by

• Location
  Address

Personal Health & Hygiene

• Do you have any flu symptoms such as headaches, running nose, sore throat, cough or fever?

  Yes

  No

• Has anyone in your home travelled overseas in the past two weeks?

  Yes

  No

• Do you have hand sanitizer and face masks on hand?

  Yes

  No

Workspace

• How would you describe your home office

  Dedicated office space

  Desk / table in a shared room

  Work from bed

  Other

• During the work day, are you likely to be distracted by others in the home?

  Not at all

  Sometimes, but not often

  Frequently

  Unsure

• Take some photos of your work area

  Media

• Is there anything that can be done to improve your working from home environment?

  Yes

  No

Workstation

• Do you have a desk or table to work from?

  Yes

  No

• Is your chair set up correctly? Is your lower back supported and are your feet flat on the floor?

  Yes

  No

• Do you have enough surface space on your desk to work comfortably?

  Yes

  No

• Are your keyboard and mouse clean and within easy reach, without having to stretch?

  Yes

  No

• Can you easily reach everything that you need without twisting and straining your upper body?

  Yes

  No

Display screen

• Is your display screen clean and positioned so there is no glare from a window or light?

  Yes

  No

• Is your display screen level with your eyes so it doesn’t cause discomfort to your neck or head?

  Yes

  No

Fire & Electrical Safety

• Do you have an emergency assembly point outside of your home in place in case of fire?

  Yes

  No

• Are your smoke detectors working and checked regularly, e.g. every month?

  Yes

  No

• Do you regularly dispose of waste, including papers, to prevent a build- up of fire ‘fuel’?

  Yes

  No

• Does any electrical equipment spark or show signs of damage or deterioration?

  Yes

  No

• Do you switch off equipment when not in use?

  Yes

  No

Stress & Welfare

• Do you sit with a good posture or are you hunched over the desk?

  Yes

  No

• Are you able to carry out regular stretches at your desk to avoid stiff or sore muscles?

  Yes

  No

• Do you have easy access to first aid equipment if required?

  Yes

  No

• Do you have a window or long distance view to look at every 15 minutes to give your short sighted muscles a rest?

  Yes

  No

Slips, trips & fall hazards

• Are floor coverings, such as carpets and rugs, secure?

  Yes

  No

• Are walkways and corridors clear of trip hazards?

  Yes

  No

• Is the floor area around your desk clear of boxes, papers and wires?

  Yes

  No

Lone working

• Do you know the name and number of a manager or supervisor who you can get in touch with easily?

  Yes

  No

• Do you have a system for regularly ‘checking in’ with your employer if you are not visibly online each day?

  Yes

  No

• Is your home kept secure whilst you’re working there?

  Yes

  No

• Are important files and laptops kept locked away securely when not in use?

  Yes

  No

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