Title Page

  • Client name

  • Site address
  • Type of business

  • Workers job title

  • Company representative (name and title)

  • Date of site assessment

  • Prepared by (name and title)

  • Staff member present

  • Staff member present

Section 1. Site Assessment

Work Systems and Environment

  • 1. Are Safe Work Procedures (SWP) / Safe Work Instruction (SWI) available and are workers instructed and trained on these? TIP: SWP/SWI incorporate visual aids and communication styles for various languages.

  • 2. Are team talks conducted regularly by SRS? (e.g. weekly/monthly). TIP: Take a photo or request a copy of a completed team talk.

  • 3. Have workers been provided with information on work schedules? TIP: Review induction records.

  • 4. Have workers been provided with instructions and education on how to use chemicals safety?

  • 5. Have workers completed de-escalation violence and aggression training? TIP: Compliance training includes videos on the topic. Examples may include a Team Talk on Aggression and Violence.

  • 6. Do the workers know who their Health and Safety Representative (HSR) is? TIP: Every facility has an assigned HSR.

All Areas

  • 7. Has the "Induction to Site Form" been completed?

  • 8. Are workers aware that the "Home Visit Safety Check" for the participants home needs to be reviewed?

  • 9. Are workers wearing work appropriate attire? TIP: Closed toe shoes and gloves as required.

  • 10. Is equipment readily available for workers? TIP: Cleaning van is equipped with vacuums, roller cleaners, mops, buckets, sprays and wipes.

  • 11. Are workers taking scheduled breaks during shifts ?

  • 12. Are Safety Data Sheets (SDS) available for all cleaning products used?

  • 13. Is work scheduled when participants are not home (where possible) ? TIP: This reduces the risk of exposure to biological hazards and aggression and violence.

  • 14. Are work areas free from hazards that may create a slips/trips/falls risk? TIP: Walkways and corridors clear.

  • 15. Emergency exits clear and accessible? TIP: No equipment or furniture in doorways and hallways.

  • 16. Is peer supervision available? TIP: Another worker or more experienced colleague provides oversight or guidance.

  • 17. Do workers have a personal mobile phone available for use? TIP: Mobile phones can be used during emergencies and for personal safety. Workers have emergency numbers stored in their phones.

  • 18. Has an emergency plan been prepared for the worksite? TIP: Take a photo of the site emergency plan or explain in notes section types of emergencies covered and how information is provided to workers.

  • 19. Does electrical equipment appear to be in good condition? TIP: take a photo of the electrical equipment and leads in the working areas where workers will be performing tasks, as well as a picture of the tag indicating the date of the last test and the date of the next scheduled test, or explain in the notes what you observed at the time of the visit.

  • 20. Are first aid kits available in vehicles and suitably trained first aiders on all shifts (provide details of first aid arrangements)? TIP: take a photo of first aid kits in the workplace, or explain in the notes where kits are located, and the type of kits available e.g. snake bite kits (where there is a risk of snake bite incidents)

Validation of Risk Control Measures

  • Has the site inspection identified adequate risk controls for all hazards identified in the JSA?

  • Escalate to the Regional Manager for discussion with the WHS Consultant, HR Manager and/or Director Labour Hire.

Next Review

  • Next review date Note: the review date is 6 months from the date the site inspection was completed.

  • Has the review been set as a reminder in the email calendar?

  • Schedule the review date on your email calendar. If you need assistance, please ask a MADEC team member.

Summary

  • Is further follow-up required at the worksite?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.