Title Page
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Conducted on
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Prepared by
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Location
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On arrival, is there a system to verbally confirm with workers that they are symptom free? No one with Symptoms is permitted on site.
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The Service Victoria COVIDSafe Construction Declaration has been completed & submitted for each worksite by the site investigations project manager or site supervisor.
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Prior to pre-start, is there a system to confirm all workers & visitors are vaccinated or hold a valid medical exemption?
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All workers are to complete the AJM Daily Self Declaration each day they are on site. Is there a system in place, prior to the pre-start to verbally confirm that all workers have completed AJM Daily Self Declaration.
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Is there a system to ensure prior to the prestart, that all workers are to be temperature tested either by the Site Supervisor / Site COVID Marshal or the nominated First Aider using a non-contact thermometer?
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Does the person conducting screening understand they must wear mask (minimum P2/N95 standard)?
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Are persons with temperatures of 38oC or more, not permitted to enter site / commence work. Isolate the affected person away from the worksite and other workers?
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Has it been communicated to all site personnel that anyone with a temp more than 38oC or that refused to be temperature tested is not permitted on site?
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Is there a system to ensure that on arrival all workers and visitors scan the Service Victoria QR Code for the work site / work activity?
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Is there a current Covid-19 Safe Plan onsite and readily available for reviewing?
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Has the Covid-19 Safe Plan been communicated to the site personnel?
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Is there a Covid-19 Marshall onsite?
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Who is the nominated Covid-19 Marshall?
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Has the Covid-19 Marshall undertaken the appropriate training?
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Are there hand sanitiser stations in a prominent location around the worksite?
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Are there signs or posters around the worksite on keeping at least 1.5 metres distance between everyone at the workplace?
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Are there onsite portable toilets provided when working on occupied sites to avoid the use of on site amenities used by other workgroups?
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Has each worker been made aware of that they are responsible for cleaning touched surfaces before & after toilet use?
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Is the toilet well stocked with hand wash and disinfectant wipes or paper towel?
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Are there cleaning products and disinfectants provided in the toilet?
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Is there a means to record when the toilets are cleaned?
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Have all workers been instructed on ways to limit the spread of germs, including by not touching their face, sneezing into their elbow, and staying home if feeling sick?
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Have the site personnel been instructed to limit contact with others– no shaking hands or touching objects unless necessary?
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Have the workers been instructed to wear gloves when cleaning and wash their hands thoroughly with soap or use an alcohol-based hand sanitiser before and after wearing gloves?
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Are signs displayed about how to wash your hands and the signs and symptoms of COVID-19 in the workplace?
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Workers are to have a mask available at all times and a face mask is to be worn at all times, including all Indoor work, Outdoor work and when travelling with others unless otherwise medically exempt. Masks may also be lowered while eating, drinking or smoking provided that this is done more than 1.5m away from others.
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Are all personnel carrying a valid Worker Permit issued by their employer.
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Is the site compliant or non-compliant.
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