MADEC Client WHS Assessment - JSA Only - Sep 2023

• Company name

• Location
  Address

• Type of business

• Company representative (name and title)

• Conducted on

  Date

• Prepared by (name and title)

Client + Job Information

• Location of the job (list all worksite addresses this work will be performed at)

• Workers' job title (note: ensure it reflects the work they will be performing)

• Description of job

• Work schedule

• 1. Will any MADEC workers need to operate quad bikes or side-by-side vehicles (SSVs)? Note: this includes ATVs, RTVs, and UTVs.

  Yes

  No

• 1.a) Has the MADEC Senior Leadership team provided authorisation for the use of these types of vehicles?

  Yes

  No

• Before allowing a worker to operate this type of vehicle, you need to obtain approval from the MADEC senior leadership.

• 2. Will any MADEC workers be required to operate any plant, mobile plant and machinery? e.g. packing shed machinery, forklift, trackers, bagging machines

  Yes

  No

• 2. a) List all plant / mobile plant / machinery to be operated

• 2. b) Will training on Safe Work Procedures associated with the operation of this plant / mobile plant /machinery be provided to MADEC workers?

  Yes

  No

• 3. What qualifications, licenses, and/or skills are required for the MADEC worker to safely perform their job?

• 4. Are any vaccinations required?

  No

  Yes

• What vaccinations are required?

• 5. What is the name of the person who will supervise the worker?

• 6. Who should the worker raise health and safety issues with?

• 7. Is there a Health and Safety Representative onsite?

  Yes

  No

Work Appropriate Attire

• Work-appropriate attire is clothing that is suitable for the nature of work, and is not necessarily PPE. They are the clothing requirements set by the host employer, however not for the purposes of managing health and safety risk. Identify below the required work-appropriate attire, and who will provide this.

• Closed-toe shoes

• Who will provide this clothing?

  The Worker

  MADEC

  The Host

• Long pants

• Who will provide this clothing?

  The Worker

  MADEC

  The Host

• Long-sleeved shirts

• Who will provide this clothing?

  The Worker

  MADEC

  The Host

• Gumboots

• Who will provide this clothing?

  The Worker

  MADEC

  The Host

• Gloves i.e., required for produce protection not for the workers health and safety

• Who will provide this clothing?

  The Worker

  MADEC

  The Host

• Raincoat

• Who will provide this clothing?

  The Worker

  MADEC

  The Host

• Other work appropriate attire. Note: list any other work appropriate attire and identify who will provide this clothing.

Personal Protective Equipment

• Personal Protective Equipment worn by workers to reduce their risk of exposure to hazards.

• Hi-visibility clothing

• Who will provide this PPE?

  MADEC

  The Host

• Protective footwear (e.g., safety boots)

• Who will provide this PPE?

  MADEC

  The Host

• Eye protection (e.g., goggles, glasses)

• Who will provide this PPE?

  MADEC

  The Host

• Face shield (clear)

• Who will provide this PPE?

  MADEC

  The Host

• Welding helmet, jacket and hood

• Who will provide this PPE?

  MADEC

  The Host

• Gloves i.e., required to manage health and safety risks to the worker

• Who will provide this PPE?

  MADEC

  The Host

• Skin protection e.g., sunscreen, broad-brimmed hats

• Who will provide this PPE?

  MADEC

  The Host

• Respiratory protection e.g., respirator, face masks, cartridge filters)

• Who will provide this PPE?

  MADEC

  The Host

• Hearing protection e.g., ear plugs, ear muffs

• Who will provide this PPE?

  MADEC

  The Host

• Clothing and body protection e.g., aprons, safety harnesses

• Who will provide this PPE?

  MADEC

  The Host

• Other personal protective equipment. Note: list any other PPE and identify who will provide this clothing.

Hazards associated with the Job

• For any of the hazards that you select yes to, that cannot be validated in the Client WHS Assessment, create an action under the applicable hazard or refer to the corresponding action created in the Client WHS Assessment.

• Areas where pedestrians and vehicles interact

  Yes

  No

• Asbestos

  Yes

  No

• Silica Dust

  Yes

  No

• Manual tasks

  Yes

  No

• Use of tools and/or knives

  Yes

  No

• Confined spaces

  Yes

  No

• Plant, and Machinery

  Yes

  No

• Electrical

  Yes

  No

• Falling objects

  Yes

  No

• Fatigue

  Yes

  No

• Hazardous chemicals

  Yes

  No

• High Job Demand

  Yes

  No

• Bacterial diseases e.g., leptospirosis

  Yes

  No

• Slips, trips and fall hazards

  Yes

  No

• Work that requires a High Risk Work (HRW) Licence

  Yes

  No

• Working at heights

  Yes

  No

• Working in hot or cold environments

  Yes

  No

• Working remote or isolated work

  Yes

  No

• Has the Client WHS Assessment identified adequate risk controls for all hazards identified in the JSA?

  Select Yes, the Client WHS Assessment has validated the risk controls for all hazards deemed relevant to the job in the JSA No, the Client WHS Assessment has not yet validated the risk controls for all hazards deemed relevant to the job in the JSA

  • Yes, the Client WHS Assessment has validated the risk controls for all hazards deemed relevant to the job in the JSA
  • No, the Client WHS Assessment has not yet validated the risk controls for all hazards deemed relevant to the job in the JSA

• Escalate to the Regional Manager for discussion with the WHS Consultant, HR Manager and/or Director Labour Hire.

• Next review date Note: the review date is 6 months from the date the site assessment was completed.

  Date

• Has the review been set as a reminder in the email calendar?

  Yes

  No

• Schedule the review date on your email calendar. If you need assistance, please ask a MADEC team member.

• Will MADEC proceed with placement?

  Yes

  No

• Explain the reasons why MADEC will not proceed with placement