Title Page
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Department
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Name of person completing report
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Date report completed
Accidents / Incidents / Near Misses
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Has there been any incidents during the reporting period?
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Has the incident been reported via Bamboo and to the SHEQ department?
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Has the incident been suitably investigate?
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Who carried out the investigation?
Department New Starters
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Have you had any new starters in the past 3 months?
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Has the new starter completed all their mandatory training?
Training Requirements
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Do any members of your department require any specific training?
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Please provide details of your training requirements to Ian Carmichael at the Training Academy.
Work Equipment (PUWER & LOLER)
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Has all of your work equipment been added to the PUWER or LOLER registers?
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Please ensure all work equipment within your department are added to the respective registers and information provided as detailed.
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If you have Harnesses , Lanyards and Tetra Kits in your department, do they all have an up to date 6-monthly thorough examination?
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Please ensure you notify Sean Wolstenholme to arrange a thorough examination. Sean will also update the register as evidence of the exams taking place.
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Is your work equipment in good working order with zero defects?
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Please ensure item(s) are quarantined until repaired or removed from general use.
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Have you recently removed an item of work equipment from use due to being faulty, damaged or not suitable?
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Has this item been removed from your register?
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Please ensure the item is removed or marked as no longer in use.
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Have you recently removed an item of work equipment from use due to being faulty, damaged or not suitable?
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Has this item been removed from your register?
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Please ensure the item is removed or marked as no longer in use.
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Do you have any lifting equipment or accessories such as chains, Inertia reels or confined space rescue equipment etc?
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Do all lifting accessories and equipment used for lifting persons have an up to date 6-monthly thorough examination, with all other lifting equipment having a 12-monthly thorough examination?
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Remove equipment from service until item(s) have received an inspection from a trained competent person/organisation.
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Does any work equipment consist of hydraulic lifers and/or air compressors.
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Do they have an up to date annual thorough inspection?
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Do not use equipment until an inspection has been completed by a competent person or organisation.
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Does your department manage MEWPS?
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Do they have an up to date LOLER certificate provided by Davis Access or another organisation?
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Stand down MEWP operations until LOLER inspection has been completed. Also, contact the SHEQ department to inform of outstanding inspection.
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Does your department manage Ladders?
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Can you confirm that all ladders are in a good state of repair, been inspected within the last 6-months and safe for use?
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Place ladders in quarantine until safe to use. Any damaged ladders are to be taken out of service.
Health & Safety
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Are all work activities covered by an up to date Risk Assessment (RA) and Safe System of Work (SSOW)?
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Please provide details of activity requiring a specific RA and SSOW.
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Are all COSHH items accompanied with a COSHH assessment and/or Safety Date Sheet?
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Provide details of substance being used.
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Do you have lone workers within your department, and if so have they been added to the lone working platform (SHEQSY)?
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Have all lone workers been trained on the department lone working procedures and signed a copy of the lone worker risk assessment..
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Ensure all lone workers receive the necessary training and sign the lone working risk assessment before conducting lone working activities.
Signature
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Full name and signature of manager completing report
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Name and signature of SHEQ department representative acknowledging report content.