Demo One DOA-15 Site Induction & Briefing

• Project Number

• Project Name

• Name of Person Inducted [Inductee]

• Mobile Phone Number

• Date Commencing on Site

  Date

• Induction carried out by Demo Site Supervisor

• This form is to be completed before starting work on site. Demo One treat all the information provided on this form as strictly confidential. All information will be held in accordance with the principles of legislation [GDPR and DPA] and ethics. Please read this form carefully before signing to confirm you have been made aware of all hazards, emergency procedures, first aid points, location of asbestos containing materials and all other site safety procedures as listed within this induction document.

Personal Details

• Date of Birth

  Date

• Male / Female

  Male

  Female

• Nationality

• Profession / Trade

• Next of Kin

• Next of Kin Contact Number

The following questions are to ascertain whether the inductee will be able to undertake job functions intrinsic to the site works

• Do you have a pre-existing injury or medical condition / disability that would affect your ability to do this work?

  Yes

  No

• Please provide details of the injury / disability or medical condition, and any current restrictions it may have on your ability to do this work.

• Are there any ways we may be able to reasonably accommodate your restrictions which would enable you to do this type of work?

  No

  Yes

• Please provide details.

• Are you currently taking any medication and / or require an aid to do this work?

  Yes

  No

• Please provide details.

• Have you any allergies which you are aware of?

  Yes

  No

• Please provide details.

Employment details and competency

• Have you worked on a demolition / asbestos site before?

  No

  Yes

• PLEASE NOTE: The inductee must be with an experienced person at all times until fully aware of site conditions and the working protocols of a demolition / asbestos site, and only once the Site Supervisor can confirm the necessary experience has been achieved.

• How many years have you worked in your profession / trade?

• Please give the name of your direct employer [company].

• Who is your supervisor on site?

Areas which must be covered as a MINIMUM within the site specific safety induction

• The following items have been explained to the inductee [please tick to confirm]

• The location of ALL known asbestos containing materials [ACM] on site, and the location of the asbestos survey report for reference.

• The Demo One Health & Safety, Environmental, Quality and other company policies and procedures e.g. COSHH and COVID-19

• The Demo One Anti-Bribery policy must also be explained during the induction.

• Task specific risk assessment method statement (RAMS) plan of works and all relevant sections of the Construction Phase Plan (CPP).

• There must be no deviation from the RAMS / COSHH assessments without first consulting the Demo One Site Supervisor / Contract Manager and permission sought and given in writing i.e. appropriate changes have been made to the relevant paper work.

• The right to refuse to work on the grounds of safety and health.

• The allocation of safety responsibilities on site.

• Site specific rules and procedures.

• All site specific and general hazards in and around the site and work area.

• The controls in place to reduce the risk from the hazards on site including any permit to work requirements.

• Site fire and emergency procedures, including the location of fire assembly point and fire extinguisher locations.

• First Aid: names and locations of first aiders plus location of first aid facilities and rules for use.

• Availability and storage of personal protective equipment (PPE) and clothing.

• The procedures for reporting accidents, injuries and near misses.

• Welfare: location of canteen, toilets, drying room etc. and other welfare matters.

• The importance of hygiene, health and site housekeeping.

• Site smoking policy and allowed smoking areas.

• PLEASE NOTE: These are the minimum requirements of the site-specific safety induction. Other additional site-specific matters may need to be added. Any other areas raised need to be recorded below.

Extra or additional matters raised as part of the site-specific safety induction

• Please detail any extra or additional matters (if any) and / or any comments raised by the inductee

Declarations

• I the undersigned agree to abide by Demo One site rules in respect of all health, safety, environmental, quality and all other company policies and procedures. My failure to comply with the aforementioned policies and procedures may result in disciplinary procedures.

• I acknowledge my failure to comply with identified risk control measures may adversely affect any civil case I might bring in the event of being injured or my property damaged whilst at work.

• I agree I have the appropriate PPE for the site operations I shall be undertaking and will wear it at all times.

• I also agree I have been fully briefed on and confirm my understanding of the risk assessment method statement plan of work for the tasks I will be undertaking whilst on site.

• Signature of Inductee

  Sign

• Signature of Demo One Site Supervisor

  Sign