Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
Heat Action Plan
Initial Check
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How many documented incidents of heat-related illnesses have been reported in the past year, if any?
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Can you provide a copy of the heat action plan for review purposes?
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When was the last time the heat action plan was reviewed and updated?
Heat Risk Assessment
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Identify heat risks within the indoor working area
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Identify heat risks within the outdoor working area
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What control measures are in place to mitigate these risks?
Existing Heat Safety Practices
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Are all workers provided with adequate breaks and access to shaded or air-conditioned rest areas during hot weather?
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Are there adequate water breaks and water refilling stations accessible to all employees?
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Are there multiple control measures in place for various risks, incidents, and accidents?
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Have these control measures properly communicated to all employees in the last quarter?
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Is there a documentation practice in place for recording any heat-related illnesses and their respective corrective action or control measure?
Heat Safety Training
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Are employees properly trained on heat safety practices and emergency procedures regarding heat illnesses and injuries?
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Are employees provided with the right educational materials for heat safety?
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Are simulated heat emergencies carried out regulary as part of employee training for heat safety?
Emergency Preparedness
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Please describe the procedures outlined in the heat action plan for heat stress prevention and response.
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Is there an alert system in place for when heat levels exceed safe working levels?
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Have all the emergency preparedness procedures been properly communicated to employees?
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Are reminders regarding heat and summer safety sent to employees regularly, even outside of summer?
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Is the business properly equipped with the right supplies to deal with a heat emergency, should one arise?
Notes
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Are there any feedbacks from employees regarding this heat action plan? If yes, list them down here.
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Are there any points for improvement or review, if needed? If yes, list them down here.
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Signature