Title Page

  • Client / Site

  • Location
  • Conducted on

  • Prepared by

Preliminary

  • Task name

  • Task description (detailed)

  • Location

  • Load weight

  • Frequency of lift

  • Carry distances (if applicable)

  • Personnel involved

Lifting and Carrying

  • Do the tasks involve:

  • holding loads away from torso?

  • twisting?

  • stooping?

  • reaching upwards?

  • large vertical movement?

  • long carrying distances?

  • strenuous pushing or pulling?

  • unpredictable movement of loads?

  • repetitive handling?

  • insufficient rest or recovery?

  • a work rate imposed by a process?

  • Are the loads:

  • heavy?

  • bulky or unwieldy?

  • difficult to grasp?

  • unstable or unpredictable?

  • intrinsically harmful (eg sharp/hot)?

  • Consider the working environment
    Are there:

  • constraints on posture?

  • poor floors?

  • variations in levels?

  • hot/cold/humid conditions?

  • strong air movements?

  • poor lighting conditions?

  • Consider individual capability
    Does the job:

  • require unusual capability?

  • pose a risk to those with a health problem or a physical or learning difficulty?

  • pose a risk to those who are pregnant?

  • pose a risk to new workers/young people?

  • require special information/training?

  • Regarding protective clothing

  • Is movement or posture hindered by clothing or personal protective equipment?

  • Is there an absence of the correct/suitable PPE being worn?

  • Work organisation (psychosocial factors)

  • Do workers feel that there has been a lack of consideration given to the planning and scheduling of tasks/rest breaks?

  • Do workers feel that there is poor communication between managers and employees (eg not involved in risk assessments or decisions on changes in workstation design)?

  • Are there sudden changes in workload, or seasonal changes in volume without mechanisms for dealing with the change?

  • Do workers feel they have not been given enough training and information to carry out the task successfully?

Remedial Actions

  • List the remedial steps that should be taken, in order of priority
    Click + to add a step

  • Action
  • Enter remedial step or action

  • Person responsible for implementing controls

  • Target implementation date

  • Date by which all actions should be completed

  • Date for review of assessment

Completion

  • Full Name and Signature of Assessor

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.