Title Page
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Name
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Conducted on
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Home location you're working from
Overview (optional)
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This section is optional and will be used for general information purposes
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How would you describe your home working environment?
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During the work day, are you likely be distracted by others?
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Take some photos of the area that you will be working from
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Is there anything that your employer can do to improve your working from home setup?
Desk Area
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Do you have a desk / table to work from?
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Do you have adequate space to work comfortably?
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Is there enough space underneath your desk to stretch your legs?
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Are there trailing electrical cables around your working area that need to be tied up?
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Is your working area warm, well-lit and well-ventilated?
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Do you need a desk lamp to improve lighting?
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Is your working area clutter free so that you can focus easily on the task?
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OK, thanks for letting us know
Display Screens Set-Up
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Is your chair set up correctly? Is your lower back supported and are your feet flat on the floor?
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Do you have enough surface space on your desk to work comfortably?
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Are your keyboard and mouse clean and within easy reach, without having to stretch?
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Is your display screen clean and positioned so there is no glare from a window or light?
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Is your display screen level with your eyes so it doesn’t cause discomfort to your neck or head?
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Can you easily reach everything that you need without twisting and straining your upper body?
Fire & Electrical Safety
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Are your smoke detectors working and checked regularly, e.g. every month?
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Do you regularly dispose of waste, including papers, to prevent a build- up of fire ‘fuel’?
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Does any electrical equipment spark or show signs of burns and so needs removing from use?
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Do any wires look damaged or frayed and so need removing from use?
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Do you regularly inspect your electrical equipment to check for signs of wear and tear?
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Do you switch off equipment when not in use?
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Do you have emergency arrangements in place in case of fire?
Stress and Welfare
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Do you take regular breaks away from your workstation?
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Do you carry out regularly stretches at your desk to avoid stiff or sore muscles?
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Do you sit with a good posture or are you hunched over the desk?
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Do you have easy access to first aid equipment if required?
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If you regularly use a computer, do you have your eyes tested every year?
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Can you easily reach everything that you need without twisting and straining your upper body?
Slips, Trips & Falls
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Are floor coverings, such as carpets and rugs, secure?
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Do you frequently carry hot drinks and food upstairs/downstairs and risk tripping?
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Are stairways and corridors clear of trip hazards?
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Is the floor area around your desk clear of boxes, papers and wires?
Lone Working
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Do you know the name and number of a manager or supervisor who you can get in touch with easily?
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Do you have a system for regularly ‘checking in’ with your employer if you are not visibly online each day?
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Is your home kept secure whilst you’re working there?
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Are important files and laptops kept locked away securely when not in use?
Manual Handling
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Are all items that you need for work within easy reach?
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Are heavy items stored on lower shelves to avoid the need for lowering them?
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Do you know how to correctly pick up, carry and lower heavy items?
Sign off
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Signature
