Induction Checklist & Record

Title Page

Site conducted
Date

Induction checklist & record

All Employees, CIS and agency workers are to complete part 1,2 & 3

NEW Employees, CIS and agency workers must complete part 4 & 5:
If a CIS inductee has not transferred immediately from another Northfield project, they are to complete the form as a NEW inductee

For each worker to be inducted just simply press the + sign to induct a new worker

The score for this induction completion must be 100%. Do not submit completion until 100% has been scored.
Worker Full Name
Contact Telephone Number

Part 2: Inductee Emergency Contacts & medical questionnaire

Next of Kin's Name & relationship
Next of Kin's contact number & address
We may need to contact you to help us assess which work is suitable for you and to agree sensible control measures to ensure your conditions do not worsen

Please answer the following:
Do you take any prescribed medication?
Provide details of medication and the amount taken per day.
Are you receiving treatment for any ongoing medical issue?
Provide details
Do you have any old injuries that still affect you?
Provide details
Do you have any mental illness?
Provide details
Do you have any conditions relating to your breathing, heart or circulation?
Provide details
Do you have any problems with your hearing or eye sight?
Provide details
Do you have any ongoing bone, muscle or joint problems (e.g. allergic to products or have vibration injuries)?
Provide details
Do you have any skin problems (e.g. allergic to products or have vibration injuries)?
Provide details
Any blood or metabolic conditions (e.g. Anaemia/diabetes)?
Provide details
Any neurological conditions (e.g. Vertigo/Epilepsy)?
Provide details

Part 3: Induction Checklist

Confirm your induction has provided the following information and instructions

Managers must ensure all the information items below can be answered 'YES' and where the worker has answered 'NO' then ensure the work has received the relevant information so that the worker can confidently answer 'YES' to the following questions in section 3.
Description of work (as applicable: your role, overview of your project, daily routines, introduction to the work environment).
Project / site or work location rules and organisational rules
Reporting & communication procedures (accident, near misses, hazards or questions, good ideas and being consulted, phone and radio restrictions, briefings and toolbox talks, work safe policy).
First aid (facilities and first aiders on site)
Drug and alcohol policy
PPE (mandatory requirements)
Welfare arrangements (eating, drinking, washing, toilets, rest & drying facilities, smoking areas).
Manual handling - maximum weights & assessments
Permit to work - describe procedures.
Your supervisors and managers (the organisation and those to go to for help).
Emergency procedures (alarms, assembly areas, exit routes and emergency equipment).
Safe Working (you have a clear understanding of which policies, arrangements, RAMS & permits are applicable to your role and your task/responsibilities have been explained).
Discipline (card system).
Site Layout (facilities, access/egress, parking and security restrictions).
COSHH assessments (instructions and arrangements received for the products you will use).
Environment, materials storage and waste disposal (arrangements and procedures).
if you have answered NO to any of the questions in section 3, STOP, do not complete the rest of the form and inform the inducting manager to provide you with the relevant information. Only change your answer to 'YES' to the questions under section 3 when you are confident you understand all of the information provided to you..
Are you NEW to Northfield Construction Ltd?
If a CIS inductee has not transferred immediately from another Northfield project, they are to complete the form as a new inductee.

Part 4: Inductees NEW to Northfield Construction Ltd

If a CIS inductee has not transferred immediately from another Northfield project, they are to complete the form as a new inductee.
Tell us what you are competent to do below (you must answer each question, select N/A if not applicable)

You must upload photo evidence of all selected competencies e.g. CSCS card, height awareness certifcate, IPAF ticket and it must display: Ticket name, number & expiry date

Example: CPCS A40a Slinger / signaller.
Ticket number: 0546532
Expiry date. 31/04/2025

If the competency doesn't have a ticket number or expiry date type N/A. you must still upload a photo of any certificates or competence cards

Part 4 a) Your Trade Competencies

Select all that apply (select N/A if not applicable)
- Concreter
- Engineer
- Formwork erector/striker
- Ground Worker
- Joiner
- Labourer
- Scaffolder
- Steel Fixer
- Stores / Logistics
- Manager
- Supervisor
- Other
- N/A
Detail 'other' trade competencies

Part 4 b) Plant & Tools Competencies

Select all that apply (select N/A if not applicable)
- AP (Crane)
- Banksman
- Pump Operator
- Breaker
- Scabbler
- Crane Supervisor
- Excavator
- Ride on roller
- Drills
- Stihl Saw
- Slinger Signaller
- Forklift
- Telehandler
- Circular Saw
- Grinder
- Crane Operator
- Dumper
- Whacker Plate
- Poker
- Cable Avoidance - CAT
- Other
- N/A
Detail 'other' Plant & tools competencies

Part 4 c) Height Competencies

Select all that apply (select N/A if not applicable)
- Height awareness
- MEWP
- Ladders & Steps
- Leading Edge
- Edge Potection
- Crane Rescue
- Harness and lanyard
- Mobile Tower
- Scaffolding
- Crane Rescue
- Tower Scaffold
- Other
- N/A
Detail 'other' Height competencies

Part 4 d) Other Competencies

Select all that apply (select N/A if not applicable)
- Asbestos
- Abrasive Wheels
- Confined Spaces
- Fire Marshal
- Manual Handling
- Environmental
- Dust-face fit tested
- Fire Marshal
- Temporary Works
- First Aid
- Other
- N/A
Detail 'other' trade competencies

Part 4 Competence Evidence

Upload evidence of all selected competencies. Where required by the competency the evidence must include: Ticket Name Ticket Number Expiry Date NOTE: Some competencies don't have ticket numbers, you must still upload evidence e.g. height awareness course certificate.

Part 5. Induction Documentation and eligibility to work checks.

You must provide proof of ID and eligibility to work. upload a photo of your ID & Residency card.

You must answer each question.
Proof of ID (choose one option)
- Passport
- Birth Certificate and a photo ID
Upload a photo of your ID
What is your citizenship / residence status?
Home Office Settled Status Number
Upload a picture of your residence card
Biometric residence permit number
Non-UK Passport number
are you a CIS Worker?
Contract for services. indigo From: ISE-CIS-S1
Personal Details. Indigo: form 'REG'

Inductee's signature

By signing below I confirm that i have answered the questions within this form truthfully and to the best of my knowledge and that I have the right to work in the UK.

Once you have signed the below, pass this Laptop / Tablet onto the inducting manager to sign.
Name & Signature

Inducting Manager's Signature

Part 2: Medical Questionnaire: If the worker has said "yes" to any of the questions in the medical questionnaire, the report will 'flag' the issue on submission of the report and prompt action. Action required: Have you ensured the worker has provided details of the medical issue and you have consulted with the H&S Manager?
Part 3: Induction checklist: Has the inspection scored 100%? IMPORTANT! Do not submit completion until 100% is scored. Note: if the inductee answers 'No' to any question in Part 3 the question will 'flag' on submission of the report. Managers must ensure they have provided the worker with all the information required so that they can confidently answer 'Yes'. e,g, re-brief of drug & alcohol policy.
Additional comments or notes (if required)
By signing below, I have confirmed the inductee has completed the form correctly & has scored 100% and uploaded photos of their competency card/s and proof of right to work in the UK.
Name & Signature