Site Coordinator's Site Assessment Form

Activity description

Weather

Hazards Checklist – run through all identified hazards and solutions with participants Describe or identify any hazards that may impact participants activities. (List below or use separate Hazards Checklist and attach it.)

Before you begin your works, make sure you can tick off the following. If you can’t, you should contact Council before continuing with the activities.

A first aid kit is located on site and all participants know of its whereabouts.

All participants have signed a Volunteer Registration Form and understand their responsibilities under the Volunteer’s Participation Agreement.

All participants have been notified of hazards and risks and necessary actions have been taken to remove or minimise them (see hazards checklist, which identifies site hazards).

All participants are wearing sturdy shoes, appropriate clothing (long sleeves and pants, hat, gloves, eye protection, high visibility top, etc.), and have access to sunscreen and water as well as any other personal protective equipment that is required.

There is no current fire ban or high fire danger warning, or other extreme weather conditions.

You are working with at least one other group member on site.

First aid Person: name and mobile number

High risk activities: Are you performing any high risk activities (e.g. using chainsaw or chipper)?

What is the activity?

Make sure you can also tick off the following:

The high-risk activity has been identified as necessary in your Agreed Works Plan.

Only certified volunteers are performing high-risk activities. (Council must have a copy of certificate prior to works.)

All other participants have been inducted into occupational health and safety and are aware of the risks and site rules.

If you answered NO to any of the above, do not proceed with the activity. Contact Council.

Hazards Checklist

Site Coordinator

Site and activity

The following hazards have been identified for this site or activity

Risk: Potential causes of injury or illness to people (volunteers or others)

Risk: Potential causes of damage to equipment

Risk: Potential causes of damage to property

Risk: Potential causes of damage to the environment

High risks must be included in your Agreed Works Plan or the task cannot be undertaken. Contact the Bushland Management Team on 1300 368 333 if you are in doubt

Volunteer Registration Form

If you have any questions about any part of the Agreement, please speak with a committee member of the group. You may also contact the Yarra Ranges Environmental Support Officer on 1300 368 333. Advice and assistance is always available.

Add volunteer

Person

I, the volunteer (please insert name below) agree to the following (please check all that apply):

I must observe and adhere to any risk prevention measures identified by the Site Coordinator (group representative) and report any hazards I notice immediately in order to ensure the safety of myself and others

I must respect the rights, feelings and property of all others associated with the project

I have consented to having my photo/film taken to be used for the purpose of publications and promotion. (If I do not consent, I understand that it is my responsibility to notify the photographer and deliberately avoid being in any photos.)

While participating at this event I will not consume or be under the influence of drugs or alcohol

I take full responsibility for the actions of all minors in my care and understand that I am liable for any incident which occurs as a consequence of their actions

I have notified the Site Coordinator of any pre-existing medical conditions which may affect my ability to participate in any activities and I grant the Site Coordinator’s authority to seek and/or provide medical treatment as deemed necessary

I will not behave in any way which is likely to make someone else feel offended, humiliated or intimidated, including unwanted sexual behaviour

I understand that my placement and the activities to be undertaken at this worksite will be allocated to me at the discretion of the Site Coordinator

I am aware that if I fail to adhere to these conditions of participation, and/or breach any reasonable safety thresholds, I agree to cease work or leave the worksite

Signature
Time in
Time out

Authorisation of office bearer or agreed representative

Total number of volunteers

Total number of volunteer hours

Authorisation of office bearer (or agreed representative)
I declare that the information on this form is correct and the group has agreed to follow specific instructions, requirements and guidelines in relation to volunteer activities

Add signature
Select date

MONITORING (Optional)

Progress and observations

Area / amount removed / treated

WEEDS: Method of removal

FLORA: Total number planted

FLORA: Species

FLORA: Unusual / rare flora observed

Add media

FAUNA: Species observed (direct sighting)

Add media

FAUNA: Species observed (indirect: scats, tracks)

Add media

General observations

Follow up required

Subjective quality score (out of 10): BEFORE
Subjective quality score (out of 10): AFTER
Work completed (%)

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.