Forum Recruitment Host Employer WHS Site Assessment

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• WORKSITE ADDRESS:

• INDUSTRY:

• WORKSITE ACTIVITY:

• Do you on-hire workers to other clients?

  Yes

  No

  N/A

• Do you audit the client and their site?

  Yes

  No

  N/A

• Please provide evidence of the audit procedure and a recent copy of the completed site assessment at the third party site

  Media

Do you have a doumented policy for:

• Mental health at work

  Yes

  No

  N/A

• Bullying, harassment and discrimination

  Yes

  No

  N/A

• Sexual harrassment

  Yes

  No

  N/A

• Alcohol and other drugs

  Yes

  No

  N/A

• Explain how you identify hazards in the workplace

Do you have documented safe work practices/operating procedures that address

• Induction and training

  Yes

  No

  N/A

• Risk management

  Yes

  No

  N/A

• Incident management

  Yes

  No

  N/A

• Risk Management

  Yes

  No

  N/A

• chemicals and hazardous materials

  Yes

  No

  N/A

• safe travel

  Yes

  No

  N/A

• psychosocial (i.e. bullying, job demands, working hours)

  Yes

  No

  N/A

• manual tasks/ergonomics

  Yes

  No

  N/A

• violence and aggression

  Yes

  No

  N/A

• first aid

  Yes

  No

  N/A

• emergency plans

  Yes

  No

  N/A

• electrical safety

  Yes

  No

  N/A

• Plant safety, falls from heights (for higher risk sites)

  Yes

  No

  N/A

• working alone/mobile/remote work

  Yes

  No

  N/A

• Please identify any additional hazards that are specific to the site and provide copies of associated procedures:

• Do you have an employee wellbeing program and/or a mental health support or other support available to on hire workers?

  Yes

  No

  N/A

• Safe Work Practices and Procedures (site based visits)

  Yes

  No

  N/A

• Has the company prepared a traffic management plan for the loading dock or where there are areas of risk through traffic?

  Yes

  No

  N/A

• Do you have a WHS issue resolution process?

  Yes

  No

  N/A

• Are you aware that as an Employer (Vic) or a Person Conducting Business or Undertaking (NSW), you share a primary duty of care with us in respect to our on-hire workers that are working on your site?

  Yes

  No

  N/A

• Is it likely that on-hire workers on placement will be required to work alone?

  Yes

  No

  N/A

• Do you have a working alone procedure and template communication plan?

  Yes

  No

  N/A

• Do you have consultation processes in place? e.g. health and safety committee, staff forums. If so, how are on-hire workers represented?

• Please identify the contact person(s) we should engage with to discuss any identified health and safety matters during the placement of on-hire workers

• Are you aware that you must notify us if an on-hire worker is involved in an incident, including a near miss?

  Yes

  No

  N/A

• Is there provision for emergency evacuation and first aid assistantce to on-hire workers?

  Yes

  No

  N/A

• What emergency response systems do you have in place for on-hire workers working remotely or in isolation?

• Has an emergency plan be prepared for each workplace?

  Media

• Are you aware that you are required to notify Forum Recruitment before the on-hire worker is required to perform alteranative duties, duties at a different site or when there are significant changes to the worksite the on hire worker is located at?

  Yes

  No

  N/A

WALKTHROUGH ASSESSMENT DESK AND OFFICE AREA

• Work areas free slip/trip hazards

  Yes

  No

  N/A

• Adequate lighting, glare, noise, temperature control

  Yes

  No

  N/A

• WHS information (i.e. WHS policy, procedures, posters, emergency contact details) displayed/ accessible on site. Names and photos of Health and Safety Representatives, Fire Wardens and First Aiders displayed in the workplace

  Media

• Individuals can control how their workstation is set up and organised to meet the changing demands and variety of tasks they perform

  Yes

  No

  N/A

• Chairs support the body in a way which minimises awkward postures and provides comfort. Chairs are adjusted to provide optimum support. The design of office workstations provide flexibility and adjustability

  Yes

  No

  N/A

• No observed cable-trip hazards

  Yes

  No

  N/A

• Equipment, appliance, leads in good condition, tagged and tested. No observed broken plugs, sockets, switches

  Yes

  No

  N/A

• Emergency exit signs are illuminated

  Yes

  No

  N/A

WALK THROUGH ASSESSMENT GENERAL OFFICE AREA

• First aid signage displayed

  Yes

  No

  N/A

• Cabinets and contents clean and orderly, well stocked

  Yes

  No

  N/A

• First aid kit regularly inspected and treatment of supplies recorded

  Yes

  No

  N/A

• Clear and safe access and egress to building including emergency exits and security measures

  Yes

  No

  N/A

• Is there a documented site plan that illustrates the location of fire protection equipment, emergency exits and assembly points? Is the plan and contact details accessible to all workers and current?

  Yes

  No

  N/A

• Traffic management plan displayed/easily accessible and controls in place i.e. physical barriers, designated walkways, pedestrian exclusion zones

  Yes

  No

  N/A

• Accessibility to risk assessments and safe work/operating procedures e.g. hazardous material handling

  Media

WALK THROUGH ASSESSMENT GENERAL BUILDING/OTHE PARTS OF BUILDING THE ON HIRE WORKER WILL ACCESS

• Labeled containers identify chemical and they are stored appropriately e.g. in a designated cupboard, incompatible chemicals stored separately

  Yes

  No

  N/A

• Chemical registers/safety data sheets available and easily accessible

  Yes

  No

  N/A

• Steps, stairs and landings in good condition and clear of obstructions

  Yes

  No

  N/A

• Working at heights tasks are adequately controlled by use of fall prevention devices e.g. railings, anchor points and use of harnesses (for higher risk sites)

  Yes

  No

  N/A

• Residual Current Devices (RCD’s) are used (for higher risk workplaces)

  Yes

  No

  N/A

HOST EMPLOYER DETAILS AND SIGNATURE

• HOST EMPLOYER:

• HOST EMPLOYER REPRESENTATIVE:

• SIGNATURE:

  Sign

• FORUM RECRUITMENT REPRESENTATIVE:

• SIGNATURE:

  Sign