Hand Protection Program Assessment

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Job Task 1

• Does the operator interact with the product? If yes, please enter details of the process.

  Yes

  No

  N/A

• What is the hazard?

  Select Laceration Strain/Sprain Burn Crush Entanglement Caught Between Amputation N/A

  • Laceration
  • Strain/Sprain
  • Burn
  • Crush
  • Entanglement
  • Caught Between
  • Amputation
  • N/A

• What is the severity? ( 0-1 unlikely, 2-4 first aid, 5-7 recordable, 8-10 serious injury/amputation)

• What is the probability?( 0-1 unlikely, 2-4 may occur, 5-7 will occur, 8-10 immediately hazardous)

• Does the operator wear PPE? If yes, what PPE do they wear?

  Yes

  No

  N/A

• Does the operator use any hand tools? If yes, please describe in detail the process.

  Yes

  No

  N/A

• What other tools can be utilized for this operation?

• What additional PPE is necessary for the process?

• If a tool needs to be created please draw a concept if applicable.

  Drawing

Job Task 2

• Does the operator interact with the product? If yes, please enter details of the process.

  Yes

  No

  N/A

• What is the hazard?

  Select Laceration Strain/Sprain Burn Crush Entanglement Caught Between Amputation N/A

  • Laceration
  • Strain/Sprain
  • Burn
  • Crush
  • Entanglement
  • Caught Between
  • Amputation
  • N/A

• What is the severity? ( 0-1 unlikely, 2-4 first aid, 5-7 recordable, 8-10 serious injury/amputation)

• What is the probability?( 0-1 unlikely, 2-4 may occur, 5-7 will occur, 8-10 immediately hazardous)

• Does the operator wear PPE? If yes, what PPE do they wear?

  Yes

  No

  N/A

• Does the operator use any hand tools? If yes, please describe in detail the process.

  Yes

  No

  N/A

• What other tools can be utilized for this operation?

• What additional PPE is necessary for the process?

• If a tool needs to be created please draw a concept if applicable.

  Drawing

Job Task 3

• Does the operator interact with the product? If yes, please enter details of the process.

  Yes

  No

  N/A

• What is the hazard?

  Select Laceration Strain/Sprain Burn Crush Entanglement Caught Between Amputation N/A

  • Laceration
  • Strain/Sprain
  • Burn
  • Crush
  • Entanglement
  • Caught Between
  • Amputation
  • N/A

• What is the severity? ( 0-1 unlikely, 2-4 first aid, 5-7 recordable, 8-10 serious injury/amputation)

• What is the probability?( 0-1 unlikely, 2-4 may occur, 5-7 will occur, 8-10 immediately hazardous)

• Does the operator wear PPE? If yes, what PPE do they wear?

  Yes

  No

  N/A

• Does the operator use any hand tools? If yes, please describe in detail the process.

  Yes

  No

  N/A

• What other tools can be utilized for this operation?

• What additional PPE is necessary for the process?

• If a tool needs to be created please draw a concept if applicable.

  Drawing

Job Task 4

• Does the operator interact with the product? If yes, please enter details of the process.

  Yes

  No

  N/A

• What is the hazard?

  Select Laceration Strain/Sprain Burn Crush Entanglement Caught Between Amputation N/A

  • Laceration
  • Strain/Sprain
  • Burn
  • Crush
  • Entanglement
  • Caught Between
  • Amputation
  • N/A

• What is the severity? ( 0-1 unlikely, 2-4 first aid, 5-7 recordable, 8-10 serious injury/amputation)

• What is the probability?( 0-1 unlikely, 2-4 may occur, 5-7 will occur, 8-10 immediately hazardous)

• Does the operator wear PPE? If yes, what PPE do they wear?

  Yes

  No

  N/A

• Does the operator use any hand tools? If yes, please describe in detail the process.

  Yes

  No

  N/A

• What other tools can be utilized for this operation?

• What additional PPE is necessary for the process?

• If a tool needs to be created please draw a concept if applicable.

  Drawing

Job Task 5

• Does the operator interact with the product? If yes, please enter details of the process.

  Yes

  No

  N/A

• What is the hazard?

  Select Laceration Strain/Sprain Burn Crush Entanglement Caught Between Amputation N/A

  • Laceration
  • Strain/Sprain
  • Burn
  • Crush
  • Entanglement
  • Caught Between
  • Amputation
  • N/A

• What is the severity? ( 0-1 unlikely, 2-4 first aid, 5-7 recordable, 8-10 serious injury/amputation)

• What is the probability?( 0-1 unlikely, 2-4 may occur, 5-7 will occur, 8-10 immediately hazardous)

• Does the operator wear PPE? If yes, what PPE do they wear?

  Yes

  No

  N/A

• Does the operator use any hand tools? If yes, please describe in detail the process.

  Yes

  No

  N/A

• What other tools can be utilized for this operation?

• What additional PPE is necessary for the process?

• If a tool needs to be created please draw a concept if applicable.

  Drawing

Job Task 6

• Does the operator interact with the product? If yes, please enter details of the process.

  Yes

  No

  N/A

• What is the hazard?

  Select Laceration Strain/Sprain Burn Crush Entanglement Caught Between Amputation N/A

  • Laceration
  • Strain/Sprain
  • Burn
  • Crush
  • Entanglement
  • Caught Between
  • Amputation
  • N/A

• What is the severity? ( 0-1 unlikely, 2-4 first aid, 5-7 recordable, 8-10 serious injury/amputation)

• What is the probability?( 0-1 unlikely, 2-4 may occur, 5-7 will occur, 8-10 immediately hazardous)

• Does the operator wear PPE? If yes, what PPE do they wear?

  Yes

  No

  N/A

• Does the operator use any hand tools? If yes, please describe in detail the process.

  Yes

  No

  N/A

• What other tools can be utilized for this operation?

• What additional PPE is necessary for the process?

• If a tool needs to be created please draw a concept if applicable.

  Drawing

Job Task 7

• Does the operator interact with the product? If yes, please enter details of the process.

  Yes

  No

  N/A

• What is the hazard?

  Select Laceration Strain/Sprain Burn Crush Entanglement Caught Between Amputation N/A

  • Laceration
  • Strain/Sprain
  • Burn
  • Crush
  • Entanglement
  • Caught Between
  • Amputation
  • N/A

• What is the severity? ( 0-1 unlikely, 2-4 first aid, 5-7 recordable, 8-10 serious injury/amputation)

• What is the probability?( 0-1 unlikely, 2-4 may occur, 5-7 will occur, 8-10 immediately hazardous)

• Does the operator wear PPE? If yes, what PPE do they wear?

  Yes

  No

  N/A

• Does the operator use any hand tools? If yes, please describe in detail the process.

  Yes

  No

  N/A

• What other tools can be utilized for this operation?

• What additional PPE is necessary for the process?

• If a tool needs to be created please draw a concept if applicable.

  Drawing

Job Task 8

• Does the operator interact with the product? If yes, please enter details of the process.

  Yes

  No

  N/A

• What is the hazard?

  Select Laceration Strain/Sprain Burn Crush Entanglement Caught Between Amputation N/A

  • Laceration
  • Strain/Sprain
  • Burn
  • Crush
  • Entanglement
  • Caught Between
  • Amputation
  • N/A

• What is the severity? ( 0-1 unlikely, 2-4 first aid, 5-7 recordable, 8-10 serious injury/amputation)

• What is the probability?( 0-1 unlikely, 2-4 may occur, 5-7 will occur, 8-10 immediately hazardous)

• Does the operator wear PPE? If yes, what PPE do they wear?

  Yes

  No

  N/A

• Does the operator use any hand tools? If yes, please describe in detail the process.

  Yes

  No

  N/A

• What other tools can be utilized for this operation?

• What additional PPE is necessary for the process?

• If a tool needs to be created please draw a concept if applicable.

  Drawing

Job Task 9

• Does the operator interact with the product? If yes, please enter details of the process.

  Yes

  No

  N/A

• What is the hazard?

  Select Laceration Strain/Sprain Burn Crush Entanglement Caught Between Amputation N/A

  • Laceration
  • Strain/Sprain
  • Burn
  • Crush
  • Entanglement
  • Caught Between
  • Amputation
  • N/A

• What is the severity? ( 0-1 unlikely, 2-4 first aid, 5-7 recordable, 8-10 serious injury/amputation)

• What is the probability?( 0-1 unlikely, 2-4 may occur, 5-7 will occur, 8-10 immediately hazardous)

• Does the operator wear PPE? If yes, what PPE do they wear?

  Yes

  No

  N/A

• Does the operator use any hand tools? If yes, please describe in detail the process.

  Yes

  No

  N/A

• What other tools can be utilized for this operation?

• What additional PPE is necessary for the process?

• If a tool needs to be created please draw a concept if applicable.

  Drawing

Job Task 10

• Does the operator interact with the product? If yes, please enter details of the process.

  Yes

  No

  N/A

• What is the hazard?

  Select Laceration Strain/Sprain Burn Crush Entanglement Caught Between Amputation N/A

  • Laceration
  • Strain/Sprain
  • Burn
  • Crush
  • Entanglement
  • Caught Between
  • Amputation
  • N/A

• What is the severity? ( 0-1 unlikely, 2-4 first aid, 5-7 recordable, 8-10 serious injury/amputation)

• What is the probability?( 0-1 unlikely, 2-4 may occur, 5-7 will occur, 8-10 immediately hazardous)

• Does the operator wear PPE? If yes, what PPE do they wear?

  Yes

  No

  N/A

• Does the operator use any hand tools? If yes, please describe in detail the process.

  Yes

  No

  N/A

• What other tools can be utilized for this operation?

• What additional PPE is necessary for the process?

• If a tool needs to be created please draw a concept if applicable.

  Drawing