Executive Rounding Log Sheet

• Conducted on

  Date

• Location

• Fitzroy

• East Melbourne

• Kew

• Offsite

• Department / location

• Document No.

• Conducted by

• Staff Members Rounded

What is working well?

Staff to recognise

• Source staff to be recognised from manager prior to round

Suggested improvements

• Are there any areas where we could improve? Do you have any ideas / suggestions?

• If there is one thing that could be improved, what would it be?

Tough questions / Other

• Are there questions that have been asked but cannot be answered at this time?

  Yes

  No

  N/A

• Inform the staff that you will follow up and get back to them regarding the answer

• What is the question that requires follow up?

• Date response to be provided to staff

  Date

Emergency Preparedness

• Fire doors and exit corridors are not blocked by carts, equipment, or materials or propped open?

  Yes

  No

  N/A

• Extinguishers clear of obstructions?

  Yes

  No

  N/A

• Fire Exit signs are illuminating and working properly?

  Yes

  No

  N/A

Manual Handling

• Appropriate manual handling equipment available (slide sheets, hoists, trolleys, sit to stand machine, etc.)?

  Yes

  No

  N/A

• All staff competent in practical manual handling practices?

  Yes

  No

  N/A

General Workplace Health & Safety

• All staff aware of their HSR?

  Yes

  No

  N/A

• Have recent hazards and risks been identified?

  Yes

  No

  N/A

• What has been done to manage the hazard or risk?

• Are any processes, equipment, tasks or environmental / workplace factors causing delays, frustration or concern for staff?

  Yes

  No

  N/A

• What are the issues / concerns?

• Have there been any injuries in the department?

  yes

  no

• What has been done to ensure that the cause of the injury does not happen again?

• Are staff aware of the Safety Charter.

  Yes

  No

  N/A

• How many hours have been spent on WHS in the department? <br>(Minimum of 2 hours per month)

  Yes

  No

  N/A

• Number of hours

Comments

• Additional Comments

• Signature

  Sign