Facilities & Compliance DSE Risk Assessment

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

User information

• Name

• Workstation location & number

• Add media

  Media

Display screen / keyboard / mouse

• Are characters clear and readable on screen

  Yes

  No

  N/A

• Is text size comfortable to read

  Yes

  No

  N/A

• Is image stable i.e. free from flicker etc.

  Yes

  No

  N/A

• Is screen specification suitable for intended use

  Yes

  No

  N/A

• Image adjustable in contrast and brightness

  Yes

  No

  N/A

• Screen adjustable in swivel and tilt

  Yes

  No

  N/A

• Screen free from reflections and glare

  Yes

  No

  N/A

• Is keyboard separate from screen

  Yes

  No

  N/A

• Keyboard adjustable in tilt

  Yes

  No

  N/A

• Keyboard correctly positioned to allow good keying technique

  Yes

  No

  N/A

• Keyboard characters clear / legible

  Yes

  No

  N/A

• Is mouse suitable for task

  Yes

  No

  N/A

• Mouse correctly positioned close to user

  Yes

  No

  N/A

• Wrist support available

  Yes

  No

  N/A

• Mouse operating correctly at suitable speed, response etc.

  Yes

  No

  N/A

• Add media

  Media

Software

• Is software suitable for the task

  Yes

  No

  N/A

Furniture

• Is work surface large enough for necessary equipment

  Yes

  No

  N/A

• Can user comfortably reach all equipment etc.

  Yes

  No

  N/A

• Are surfaces free from glare / reflection

  Yes

  No

  N/A

• Is chair suitable

  Yes

  No

  N/A

• Is chair stable and in good repair

  Yes

  No

  N/A

• Is seat back adjustable in height and tilt

  Yes

  No

  N/A

• Is seat adjustable in height

  Yes

  No

  N/A

• Swivel mechanism in working order

  Yes

  No

  N/A

• Castors or gliders fitted and in good repair

  Yes

  No

  N/A

• Is chair adjusted correctly to suit user

  Yes

  No

  N/A

• Is small of the back supported by chair back rest

  Yes

  No

  N/A

• Are users arms horizontal and yes roughly level with top of screen

  Yes

  No

  N/A

• Can user comfortably place feet flat on floor

  Yes

  No

  N/A

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  Media

Environment

• Adequate space to change posting and vary movement

  Yes

  No

  N/A

• Is lighting suitable to work comfortably

  Yes

  No

  N/A

• Is ventilation adequate

  Yes

  No

  N/A

• Is temperature within acceptable limits

  Yes

  No

  N/A

• Are noise levels within acceptable limits

  Yes

  No

  N/A

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  Media

Notes

• User: I acknowledge the risks identified by his assessment and will take an active role is reducing risks in line with recommendations

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  Sign

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  Date

• Assessor: I confirm that a suitable and sufficient assessment has been carried out with adequate control measures identified

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  Date