LSM NHS Guard Assessment

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• On site Date and Time

  Date

• Guards Pic

  Media

Guard Name

• Guard's Name

Shift Times

• Enter Shift Start Time

  Date

• Enter Shift Finish Time

  Date

Sign On

• On Time

  Yes

  No

  N/A

• Reported To

• Signed on Event Log

  Yes

  No

  N/A

Essentials

• Security License Viewed

  Yes

  No

  N/A

• Expire Date

  Date

• Staff ID card viewed<br>

  Yes

  No

  N/A

• Expiry Date

  Date

• NHS brief Noted and Signed (by NHS staff member)

  Yes

  No

  N/A

• Is Patient over 18

  Yes

  No

  N/A

• Are DOLS in Place

  Yes

  No

  N/A

• Has use of Force Brief been Briefed

  Yes

  No

  N/A

• Has Handover taken Place between LSM staff members

  Yes

  No

  N/A

Presentation

• Uniform Presentation

• Does staff member have appropriate PPE for task<br>

  Yes

  No

  N/A

• Comments

Site Health and Safety

• RAMS in date and Fit for Purpose

  Yes

  No

  N/A

• Check Calls Documented

  Yes

  No

  N/A

• Emergency Procedures Documented

  Yes

  No

  N/A

• First Aid Kit, Fire Extinguisher, Spill Response Kit Available

  Yes

  No

  N/A

• Emergency Contact Details Available

  Yes

  No

  N/A

• Quarantine Patient?

  Yes

  No

  N/A

Security Procedure

• Patrols Conducted and Recorded in Event Log

  Yes

  No

  N/A

• Buildings, Fences, Vehicles, Gates, Padlocks Checked for Security and Recorded in Event Log

  Yes

  No

  N/A

• Is CCTV Operational

  Yes

  No

  N/A

Site Review

• Active Guard on Site and Operational

  Yes

  No

  N/A

• Does The Guard Know His Duties and Patrol Routes

  Yes

  No

  N/A

Guards Signature

• Guard to Sign to Confirm Induction to Site

  Yes

  No

  N/A

• Sig

  Sign

Managers, Supervisors Assessment

• Verification and Comments

  Yes

  No

  N/A

Acknowledgment

• Signature of Assessor

  Sign

Office Use Only

• Review By General Manager

  Yes

  No

  N/A

• Date and Time Review Performed

  Date

• Feedback

• Signature of General Manager

  Sign