Hand Safety - duplicate

• Conducted on

  Date

• Prepared by

• Location
  Address

• Are employees required to wear appropriate hand protection in designated areas?

  Yes

  No

  N/A

• How would you rate the condition of hand protection equipment in your area?

  Good

  Fair

  Poor

  N/A

• Describe the procedure for reporting hand injuries or near-misses.

• True or False: All hand safety equipment is tested and certified.

• When was the last hand safety inspection conducted?

  Date

• Do you have the proper PPE to perform the necessary tasks?

  Yes

  No

  N/A

• True or False: you should always report incidents to safety personnel no matter the severity

Safe or At Risk

• Will you do your best to be safe while working?

  Yes

  No

  N/A

• Handling a tools without gloves

  Safe

  At Risk

  N/A

• Wearing gloves around moving parts

  Safe

  At Risk

  N/A

• Seeing where my hands are at all times

  Safe

  At Risk

  N/A

• Cutting towards myself or others

  Safe

  At Risk

  N/A

• Changing worn-out gloves for new ones

  Safe

  At Risk

  N/A

• I am prepared to preform my duties safely and efficiently

  Sign