COVID-19 PRECAUTIONARY MEASURES INSPECTION REPORT - duplicate

• Conducted on

  Date

• Prepared by

• Location
  Address

• Report no.

• 1.1 Is the temperature screening being conducted to all employees, visitors, and customers before entering the work premises?

  Yes

  No

  N/A

• 1.2 Is the thermometer functioning well (i.e. temperature range in between 35.5C- 37.5C)?

  Yes

  No

  N/A

• 1.3 Is the temperature screening being conducted in a correct manner (i.e. distance, screening point, etc.)?

  Yes

  No

  N/A

• 1.4 Are the temperature readings of the employees, visitors and customers recorded (i.e. hard copy or google form)?

  Yes

  No

  N/A

• 1.5 Are the stickers being displayed clearly for all employees, visitors and contractors after passing through the temperature screening?

  Yes

  No

  N/A

• 1.6 Are the health declaration forms available for visitors including customers & contractors?

  Yes

  No

  N/A

• 1.7 Do all the employees self-declared their health status and travel history on a daily basis?

  Yes

  No

  N/A

• 1.8 Are the health declaration forms and temperature reading records being kept properly? (At least 3 months)

  Yes

  No

  N/A

• 2.1 Are the face masks provided and worn by all employees, visitors, contractor workers, visitors and customers?

  Yes

  No

  N/A

• 2.2 Are all employees wearing the mask properly?

  Yes

  No

  N/A

• 2.3 Is the supply of face mask sufficient and proper controlled?

  Yes

  No

  N/A

• 2.4 Are the face mask issuance records available?

  Yes

  No

  N/A

• 2.5 Are the hand gloves provided for the cleaner or employee when carrying out the cleaning task?

  Yes

  No

  N/A

• 2.6 Are the sufficient rubbish bins provided and all the contaminated face masks and hand gloves disposed properly?

  Yes

  No

  N/A

• 3.1 Are the seating arrangement for offices, meeting rooms, discussion areas, customer waiting areas, staff rest areas, company shuttle, etc. maintained with a minimum one metre social distance?

  Yes

  No

  N/A

• 3.2 Are the unused chairs or tables being removed, folded or marked accordingly?

  Yes

  No

  N/A

• 3.4 Is the Surau restricted on the number of people to enter (i.e. 1-2 persons) and the praying stuff (e.g. Telekung & Sejadah) has been removed after the praying?

  Yes

  No

  N/A

• 3.5 Is the elevator restricted on the number of people to enter (i.e. 2 persons) and demarcations on the standing point clearly indicated?

  Yes

  No

  N/A

• 3.6 Are the places (i.e. washroom, pantry, smoking area, front counters, technician room, work stations etc.) free of crowds?

  Yes

  No

  N/A

• 3.7 Are the staff eating/rest areas adequate for social distancing? If not, split meal time or allocation of the additional eating area should be considered. * Staff is not encouraged to take lunch outside the work premises.

  Yes

  No

  N/A

• 3.8 Are all the employees, visitors and customers practicing minimum one metre social distance and follow the demarcations?

  Yes

  No

  N/A

• 4.1 Are the hand sanitizers available and placed at appropriate locations such as reception counter, customer lounge, temperature reading area, etc?

  Yes

  No

  N/A

• 4.2 Are the hand sanitizers provided for staff working outside the work premises?

  Yes

  No

  N/A

• 4.3 Is the supply of hand sanitizer sufficient and proper replenished?

  Yes

  No

  N/A

• 4.4 Are hand soaps available at all hand washing areas?

  Yes

  No

  N/A

• 4.5 Is the disinfection of the premises being (e.g. common area) carried out at least 3 times/day?

  Yes

  No

  N/A

• 4.6 Are the disinfectant (e.g. spray bottles) and cleaning clothes/wipes provided sufficiently to clean the tools and equipment, work desks, and company cars?

  Yes

  No

  N/A

• 4.7 Is the rubbish bin cleaned in a regular basis?

  Yes

  No

  N/A

• 4.8 Is the disinfection record available?

  Yes

  No

  N/A

• 4.9 Are the staff only purchased packed food and practicing no food sharing?

  Yes

  No

  N/A

• 4.10 Are the staff using their own utensils and crockery for their meal?

  Yes

  No

  N/A

• 5.1 Are sufficient posters and leaflets displayed clearly to inform the employees, customers and visitors on precaution measure for COVID-19?

  Yes

  No

  N/A

• 5.2 Are the employees informed/trained on the COVID-19 precaution measures at the workplace? * If yes, please provide the briefing records.

  Yes

  No

  N/A

• 5.3 Is the HOW/HOB/HOD or PIC submitting the Weekly Report of Standard Operating Procedure (SOP) during the period of the Recovery Movement Control Order (RMCO)?* If yes, please provide the latest report.

  Yes

  No

  N/A

• 5.4 Is the premise already registered with MySejahtera and displayed the QR Code at the main entrance?

  Yes

  No

  N/A

Conclusion/ Recommendation

• Compliance (%)

• Poor COVID-19 precautionary measures implementation. Immediate action is required to reduce the risk of COVID-19 infection in the workplace.

• Moderate COVID-19 precautionary measures implementation. More effort need to be implemented to ensure the measures taken is effective against the spreading of COVID-19 infection at the workplace.

• Good COVID-19 precautionary measures implementation. However, several efforts need to be implemented to ensure the measures taken are effective against the spreading of COVID-19 infection at the workplace.

• Excellent COVID-19 precautionary measures implementation. Please ensure the taken measures are effective against the spreading of COVID-19 infection at the workplace.

• Deadline

  Date

Completion

• Signature

  Sign