Information
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5.17.1 Working from Home Assessment and Agreement
This assessment is to be completed by the employee and manager prior to approving a working from home request. Once completed, the Manager is to file with their HSE records.
If an item or a condition presents a hazard that has the potential to cause an injury or illness, then it is to be assessed and risk ranked (very high, high, medium or low) by the manager and a corrective action to be recorded in PeopleSoft. For very high and high risk ranking items, working at home cannot proceed until a corrective action is implemented and reassessed. If an item is ‘Not Applicable’ then indicate NA against the item. -
Document No.
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Business Stream
- WIS
- Blackwoods
- Protector Alsafe
- Safety Source
- NZ Safety
- Australian Graphics
- Bakers
- Geminex
- Total Fasteners
- Bullivants
- Coregas
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Location
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Conducted on (Quarterly Frequency)
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Employee Name
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Managers Name
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Inspected By
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Is there a separate office available to work in? If no then a suitable work area is required and must include a suitable desk and ergonomic chair.
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Are there any sources of excessive or disruptive noise?
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Does the layout of the workspace allow easy access to equipment?
Supervision
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Has the employee received the necessary information and training to do the work safely (ergonomic and manual handling training).
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Has there been an agreement made concerning work hours, work breaks etc. and communication arrangements?
Ergonomics
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Has the GetSAFE ergonomic checklist been completed for the home work environment ( Refer to GetSAFE checklist 5.20.1)
Electrical
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Are power points in good condition?
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Have all work items such as laptops etc. had the electrical cords tested and tagged and in good condition?
Emergency Control
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Inspection conducted by
