Title Page

  • Conducted on

  • Employee Name

  • Prepared by

Lone working

  • Has the employee been issued the Evobead Lone worker policy?

  • Does the employee understand their responsibilities outlined within the policy?

  • Has the employee received the appropriate H&S Induction training for the manufacturing plant?

  • Has the employee been signed off on the Manufacturing Plant training matrix?

  • Has the employee been issued with all appropriate PPE?

  • Has the employee been made aware of all emergency contact numbers?

  • Has the employee been made aware of the CCTV recording system within the factory?

Employees Duties & Responsibilities: All Employees must

  • Comply with Evobead's "Lone Worker" policies and procedures

  • Ensure dynamic risk assessments are undertaken

  • Report unsafe activities or faulty equipment to their line manager/factory foreman

  • Report all accidents or near misses, using the Company's accident/incident reporting procedure

  • In the event of an emergency, use contact numbers provided

Training Confirmation

  • I confirm that I have read and fully understand my duties and responsibilities within the Lone Worker policy issued.

  • Employee Name

  • Employee Signature

  • Supervisor Name

  • Supervisor 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.