ITS Group - Employer Vetting Form (Standards 1-9)

• Audit Title
  
  Health & Safety Vetting Form EMP-25

• Company Name and Address.

• Location
  Address

• Conducted on

• Select date

  Date

• Prepared by

Company Details

• Company contact email

• Number of full-time employees

• Number of part-time employees

• Nature of business

Employers Liability Insurance

• Insurers name

• Policy number

• Expiry date

• Select date

  Date

• Type of work carried out at workplace location

• Main contact name

• Main contact telephone number

• Health and safety contact name and number

• Learner name(s)

• Supervisor(s) name(s)

• Enforcement actions prosecutions or notices?

  No

  Yes

• Health and safety committee/safety representation

Health and safety standards:

• 1. Health and safety policy

• A. Is there a clear commitment to health, safety and welfare (written policy statement mandatory when five or more employees)?

  Yes

  No

• B. Are the responsibilities for health and safety clearly stated (recorded when five or more employees)?

  Yes

  No

• C. Our arrangements for health and safety clearly stated (recorded 15 or more employees)?

  Yes

  No

• How are the commitment, responsibilities and arrangements for health and safety (in 1A - 1C above above) communicated to employees?

  Induction

  Training

  Other

• Assessment of standard 1

  Met

  Part Met

  Not Met

• 2. Risk assessment and control

• A. Have risk assessments being carried out and significant risks identified?

  Yes

  No

• B. Have the significant findings and details of any groups identified as being especially at risk being recorded (this is optional where there are fewer than five employees)?

  Yes

  No

• C. Have control measures been identified and put in place as a result of the risk assessments?

  Yes

  No

• D. Do the risk assessments take into account young persons, including giving consideration to their age, inexperience, immaturity and lack of awareness of risks?

  Yes

  No

• E. Give details of the risks and control measures relating to the occupations and the specific activities carried out in the workplace.

• F. How are the risks and control measure is explained to employees and others?

  Induction

  Training

  Other

• G. Are risk assessments reviewed e.g. in light of the findings from the monitoring activities?

  Yes

  No

• Assessment of standard 2

  Met

  Part Met

  Not Met

• 3. Accidents, incidents and first aid.

• A. Have adequate arrangements for first aid materials been made?

  Yes

  No

• B. Have adequate arrangements for trained first aid persons been made?

  Yes

  No

• C. Are accidents and first aid treatment rendered recorded?

  Yes

  No

• D. Are or will all legally reportable learner accidents, incidents and ill-health be reported to the enforcing authority and the Skills Funding Agency, and will they be investigated to enable suitable remedial action to be taken?

  Yes

  No

• E. How are the arrangements for accidents, incidents, ill-health and first aid made known to all employees?

  Induction

  Training

  Other

• Assessment of standard 3

  Met

  Part Met

  Not Met

• 4. Supervision, training, information and instruction.

• A. Are employees provided with adequate competent supervision?

  Yes

  No

• B. Is the initial health and safety information, instruction and training given to all new employees on recruitment?

  Yes

  No

• C. Is ongoing health and safety information, instruction and training provided to all employees?

  Yes

  No

• D. Is health and safety information, instruction and training recorded?

  Yes

  No

• E. How is the effectiveness of health and safety information, instruction and training assessed, and is the assessment recorded?

  Induction

  Training

  Other

• Assessment of standard 4

  Met

  Part Met

  Not Met

• 5. Work equipment and machinery.

• A. Is the correct machinery and equipment provided to the appropriate standards?

  Yes

  No

• B. Is equipment adequately maintained?

  Yes

  No

• C. Are guards and control measures in place as determined through risk assessments?

  Yes

  No

• D. Are safe electrical systems and equipment maintained?

  Yes

  No

• Date last tested.

  Date

• Assessment of standard 5

  Met

  Part Met

  Not Met

• 6. Personal Protective Equipment & Clothing.

• A. Is PPE/C provided, free of charge, to employees as determined through risk assessment?

  Yes

  No

  N/A

• B. Is training and information on safe use of PPE/C provided to all employees?

  Yes

  No

  N/A

• C. Is the proper use and storage of PPE/C enforced?

  Yes

  No

  N/A

• D. Is PPE/C maintained and replaced?

  Yes

  No

  N/A

• Assessment of standard 6

  Met

  Part Met

  Not Met

• 7. Fire and emergencies.

• A. Has a fire risk assessment been completed?

  Yes

  No

• B. Are there appropriate means of raising the alarm, fire detection and fire fighting equipment in place?

  Yes

  No

• C. Are effective means of escape in place including unobstructed routes and exits?

  Yes

  No

• D. Is there a named person(s) for emergencies?

  Yes

  No

• E. Is fire fighting equipment, preventive measures and emergency arrangements, including through tests and practice fire drills in place?

  Yes

  No

• Date fire extinguishers last tested.

  Date

• F. Is a fire log/record book kept?

  Yes

  No

• Assessment of standard 7

  Met

  Part Met

  Not Met

• 8. Safe and healthy working environment.

• A. Are premises (structure, fabric, fixtures and fittings) safe and healthy (suitable, maintained and kept clean)?

  Yes

  No

• B. Is the working environment (temperature, lighting, space, ventilation, noise) an appropriate safe and healthy one?

  Yes

  No

• C. Are welfare facilities (toilets, washing, drinking, eating, changing) provided as appropriate and maintained?

  Yes

  No

• D. How is exposure to hazards from physical, chemical and biological agents controlled?

  Induction

  Training

  Other

• Assessment of standard 8

  Yes

  No

  N/A

• 9. General health and safety management.

• A. How does the employer consult and communicate with employees and allow them to participate in health and safety?

  enter details

• B. Does the employer provide medical / health screening as appropriate and any required medical / health surveillance?

  Yes

  No

  N/A

• C. Does the employer have access to competent health and safety advice and assistance?

  Yes

  No

• D. Does the employer review health and safety annually?

  Yes

  No

• E. Does the employer display all the necessary signs and notices? (please enter details below)

  Yes

  No

• Does the ELI cover Public Liability? (If NO please enter details below)

  Yes

  No

• Insurers name, policy number and expiry date

• G. How does the employer assess, review and update employees' capabilities?

• H. How does the employer manage employees' work when it is away from the employers own premises or when employees are placed with another employer/site?

• Assessment of standard 9

  Met

  Part Met

  Not Met

• Equality & Diversity

• A. Is there a written policy for equal opportunities or equality and diversity?

  Yes

  No

• B. If NO, would company like a copy of provider policy?

  Yes

  No

  N/A

• Safeguarding

• A. Is there a written policy for Safeguarding?

  Yes

  No

• B. If NO, would company like a copy of provider policy?

  Yes

  No

  N/A

• Health & Safety Assessment Outcome:

• Recommendation

  Accept

  Accept with action plan

  Reject

• Risk category

  High

  Medium

  Low

The employer or their representative, please sign below to agree that this is an accurate record of the assessment.

• Add signature

  Sign

• Job title

• Date

  Date

Funded organisation assessor please sign below to agree that this is an accurate record of the assessment.

• Add signature

  Sign

• Job title

• Health And Safety Qualifications

• Date

  Date

Quality assured by

• Name

• Job title

• Date

  Date

• Assessment type

  Initial assessment

  re-assessment

  Other (please specify)

• Review Date

  Date

ACTION PLAN

• Reference number(s)

• Action(s) required

• By who?

• Target date

  Date

• Action plan prepared by

• Agreed by

• Signature of employer representative

  Sign

• Date

  Date

• Review date 1

  Date

• Review date 2

  Date

• Review date 3

  Date