Job Safety Assessment - Commercial

• Date of Inspection:

  Date

• Company:

• Site Address:
  Address

• Temp's Job Title:

• Location of Job on Site:

• Brief Job Description:

• Client Contact:

• Client Contact Position:

• Forsythes Consultant:

  Select Brigette Landy Camille Williams Emily Bowen Lauren Deighton Ty Brennock

  • Brigette Landy
  • Camille Williams
  • Emily Bowen
  • Lauren Deighton
  • Ty Brennock

• Others Consulted With:

Job Tasks

• ACTIVITY: Data Entry

• HAZARDS:
  Occupational Overuse Syndrome
  Loss of concentration due to repetitiveness

• RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RISK CONTROL MEASURES:
  Take regular breaks
  Vary tasks

• RESIDUAL RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RESPONSIBILITY:

  Select Client Candidate Forsythes Recruitment

  • Client
  • Candidate
  • Forsythes Recruitment

• NOTES:

• ACTIVITY: Reception / Telephone Duties

• HAZARDS:
  Neck strain due to overuse of the phone

• RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RISK CONTROL MEASURES:
  Ensure a headset is available for long calls or continuous telephone use

• RESIDUAL RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RESPONSIBILITY:

  Select Client Candidate Forsythes Recruitment

  • Client
  • Candidate
  • Forsythes Recruitment

• NOTES:

• ACTIVITY: Filing / Records / Stationary Handling

• HAZARDS:
  Manual handling - heavy lifting, sustained and awkward postures, repetitive motions

• RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RISK CONTROL MEASURES:
  Reduce weight of objects
  Use trolley or other equipment to assist
  Ask someone to assist
  Provide manual handling training

• RESIDUAL RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RESPONSIBILITY:

  Select Client Candidate Forsythes Recruitment

  • Client
  • Candidate
  • Forsythes Recruitment

• NOTES:

• ACTIVITY: General Administration Duties

• HAZARDS:
  Poor ergonomics

• RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RISK CONTROL MEASURES:
  Adjust workstation to suit personal requirements

• RESIDUAL RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RESPONSIBILITY:

  Select Client Candidate Forsythes Recruitment

  • Client
  • Candidate
  • Forsythes Recruitment

• NOTES:

• ACTIVITY:

• HAZARDS:

• RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RISK CONTROL MEASURES:

• RESIDUAL RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RESPONSIBILITY:

  Select Client Candidate Forsythes Recruitment

  • Client
  • Candidate
  • Forsythes Recruitment

• NOTES:

• ACTIVITY:

• HAZARDS:

• RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RISK CONTROL MEASURES:

• RESIDUAL RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RESPONSIBILITY:

  Select Client Candidate Forsythes Recruitment

  • Client
  • Candidate
  • Forsythes Recruitment

• NOTES:

General - Workplace Inspection Follow Up

• Has there been any significant changes to the workplace / new hazards identified in general since the workplace inspection was completed? e.g. Poor lighting, tripping hazards in walkways, fire exit signs not working, no fire extinguishers, no drinking water available, dangerous power leads etc.

  Select Yes No

  • Yes
  • No

• If yes, please list below:

• AREA: Psychological

• HAZARDS:
  Bullying, violence or abuse
  Stress
  Lack of communication

• RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RISK CONTROL MEASURES:
  Conflict resolution process
  Monitor workplace relationships
  Monitor workload
  Open feedback sessions / open communication

• RESIDUAL RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RESPONSIBILITY:

  Select Client Candidate Forsythes Recruitment

  • Client
  • Candidate
  • Forsythes Recruitment

• NOTES:

• AREA: Workplace and Environment

• HAZARDS:
  Poor lighting
  Extended working hours
  Poor working conditions
  Extreme temperatures
  Poor housekeeping resulting in slips, trips or false

• RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RISK CONTROL MEASURES:
  Adequate lighting
  Regular breaks / adjusted working hours
  Clear walkways and workstations
  Keep workplace clean and tidy
  Install hand rails on stairs

• RESIDUAL RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RESPONSIBILITY:

  Select Client Candidate Forsythes Recruitment

  • Client
  • Candidate
  • Forsythes Recruitment

• NOTES:

• AREA:

• HAZARDS:

• Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RISK CONTROL MEASURES:

• RESIDUAL RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RESPONSIBILITY:

  Select Client Candidate Forsythes Recruitment

  • Client
  • Candidate
  • Forsythes Recruitment

• NOTES:

• AREA:

• HAZARDS:

• Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RISK CONTROL MEASURES:

• RESIDUAL RISK:

  Select Very Low Low Medium High Critical

  • Very Low
  • Low
  • Medium
  • High
  • Critical

• RESPONSIBILITY:

  Select Client Candidate Forsythes Recruitment

  • Client
  • Candidate
  • Forsythes Recruitment

• NOTES:

Original I have been consulted in regards to the above Job Safety Assessment (JSA) and am aware of any hazards identified.

• Client Contact:

  Sign

• Forsythes Consultant:

  Sign

• Employee:

  Sign

• Employee:

  Sign

• Employee:

  Sign

• Employee:

  Sign

• Employee:

  Sign

Review: I agree that there have been no new hazards identified and the original Job Safety Assessment (JSA) applies.

• Client Contact:

  Sign

• Forsythes Consultant:

  Sign

• Employee:

  Sign

• Employee:

  Sign

• Employee:

  Sign

• Employee:

  Sign

• Employee:

  Sign