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  • Conducted on

  • Prepared by

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  • Some cleanup equipment and supplies are available.

  • Site is generally aware of chemicals present on site

  • Written program specifies:<br>• Roles and responsibilities;<br>• Requirements for those who may be exposed (i.e. first aid responders, maintenance, janitorial staff and clean-up personnel);<br>• Procedures for cleanup; <br>• Procedure for disposal of contaminated materials; <br>• Method for collecting and disposing of sharps;<br>• Procedure to be followed if someone believes they may have been exposed;<br>• Employee training requirements.<br><br>A revision log shall be included as part of the written program.

  • All employees with potential occupational exposure have equipment to prevent exposure (e.g. gloves, CPR mask, etc.)

  • Equipment and supplies are available for clean-up of potentially contaminated material.

  • "Sharps containers" are available for the collection hypodermic syringes and other potentially contaminated sharps. .

  • Written program is reviewed annually and updated as necessary. The revision log has been maintained to reflect the annual review and any other changes made to the written program throughout the year.

  • Supervisors and all employees with potential occupational exposure to bloodborne pathogens receive formalized training, including exams, upon assignment and within each 365 days thereafter.

  • Trainers are competent and qualified to train on the subject matter

  • Process exists for disposal of bio-hazard wastes.

  • All employees understand the hazards associated with bloodborne pathogens and the concept of Universal Precautions.

  • Regulations are followed regarding annual training requirements, vaccinations (Hepatitis B) and recordkeeping

  • Universal precautions are followed to prevent the spread of bloodborne pathogens.

    Hazard Communication
  • Which department are you reviewing?

  • Are all containers labeled?

  • Is chemical on a containment pallet?

  • Are labels legible?

  • Do team members know where the SDS book is located?

  • Is the department using food containers for secondary containers?


  • Supervisor's Signature

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.