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Audit

Lone workers involved

Staff

Lone worker's name and role

Individual

Medical Fitness:
Is the Lone Worker subject to any medical condition that may place them at increased risk when working alone?

Supervision: What arrangements are in place to maintain contact with the lone worker?

Training & Competency :
Has necessary information, instruction, and training been given to the lone worker?

Training & Competency: Is the lone worker competent to carry out the work alone?

Location & Premises

Building security:
Is the building secure?

Access:
Is there a safe means of access/egress for the lone worker?

Emergencies:
Does the lone worker have access to emergency warning devices to raise the alarm in event of emergency e.g. fire alarm, motion sensors /manual device (panic alarms)?

First aid:
Are there arrangements are in place to deal with a situation where the lone worker becomes ill or has an accident?

Welfare facilities:
Is there adequate heating, lighting, access to drinking water and toilets?

Process/Work Activity
Select hazards identified in the work premises

Please specify hazards

Control/Preventive Measures

Documentation
Completion
Full Name and Signature of Inspector

Lone Working Risk Assessment Template Checklist

Created by: SafetyCulture Staff | Industry: General | Downloads: 209

This lone working risk assessment template is used to identify and evaluate hazards present in the workplace to ensure that lone workers are safe during their work shifts. This template can be used by team managers and safety officers to mitigate risks before any accidents or injuries happen. The template can serve as a guide for the inspector to do the following: List lone workers involved; Assess medical fitness, supervision method and training programs in place; Evaluate the entire location and premise; Identify any hazards present and assign actions to responsible teams; Document evidence and findings by taking photos and adding some notes and complete the report by affixing a digital signature.

Signup for a free iAuditor account to download and edit this checklist. It will be added to your free account and you will be able to conduct inspections from your mobile device.

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Audit

Lone workers involved

Staff

Lone worker's name and role

Individual

Medical Fitness:
Is the Lone Worker subject to any medical condition that may place them at increased risk when working alone?

Supervision: What arrangements are in place to maintain contact with the lone worker?

Training & Competency :
Has necessary information, instruction, and training been given to the lone worker?

Training & Competency: Is the lone worker competent to carry out the work alone?

Location & Premises

Building security:
Is the building secure?

Access:
Is there a safe means of access/egress for the lone worker?

Emergencies:
Does the lone worker have access to emergency warning devices to raise the alarm in event of emergency e.g. fire alarm, motion sensors /manual device (panic alarms)?

First aid:
Are there arrangements are in place to deal with a situation where the lone worker becomes ill or has an accident?

Welfare facilities:
Is there adequate heating, lighting, access to drinking water and toilets?

Process/Work Activity
Select hazards identified in the work premises

Please specify hazards

Control/Preventive Measures

Documentation
Completion
Full Name and Signature of Inspector