Title Page

  • Company name

  • Location
  • Type of business

  • Company representative (name and title)

  • Conducted on

  • Prepared by (name and title)

Introduction

Scope

  • The scope of the Client WHS Assessment is limited to the examination of information sourced, and observations made at the time of the onsite visit. The principal objectives of this report are to:
    - Evaluate the host employers' work health and safety documentation to determine an appropriate level of understanding of WHS issues and legislation required to manage WHS risks associated with the operational activities of the business.
    - Determine if the host employer provides and implements practical systems and processes for managing WHS risks
    - Identify good practices and opportunities for improvement based on operations specific to the business.

    Having considered the matters discussed during our visit this WHS report has been finalised to provide an overview of MADEC's observations.

Confidentiality Statement

  • In order to maintain the integrity and credibility of the risk analysis processes and to protect the parties involved, it is understood that MADEC and its representatives will not divulge to unauthorised persons any information obtained during this WHS Assessment unless legally obliged to do so.

Copyright 2023

  • All rights reserved. No part of this document may be reproduced or transmitted in any form by any means, electronic or mechanical, including photocopying and recording, or by an information storage or retrieval system, accept as may be permitted, in writing, by MADEC.

Section 1 - Hazard/Task Information for Job Safety Analysis (JSA)

  • If all MADEC workers are performing similar tasks with similar risks, one comprehensive JSA can be prepared to cover these various tasks. However, if each worker has a designated, specialised role with unique risks, then separate JSAs are required for each specific task or role to ensure all potential hazards are properly addressed.

Client + Job Information

  • Client Name

  • Client Representative

  • 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.

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

  • 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

  • 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?

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

  • 4. Are any vaccinations required?

  • 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?

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?

  • Long pants

  • Who will provide this clothing?

  • Long-sleeved shirts

  • Who will provide this clothing?

  • Gumboots

  • Who will provide this clothing?

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

  • Who will provide this clothing?

  • Raincoat

  • Who will provide this clothing?

  • 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?

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

  • Who will provide this PPE?

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

  • Who will provide this PPE?

  • Face shield (clear)

  • Who will provide this PPE?

  • Welding helmet, jacket and hood

  • Who will provide this PPE?

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

  • Who will provide this PPE?

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

  • Who will provide this PPE?

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

  • Who will provide this PPE?

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

  • Who will provide this PPE?

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

  • Who will provide this PPE?

  • 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

  • Asbestos

  • Silica Dust

  • Manual tasks

  • Use of tools and/or knives

  • Confined spaces

  • Plant, and Machinery

  • Electrical

  • Falling objects

  • Fatigue

  • Hazardous chemicals

  • High Job Demand

  • Bacterial diseases e.g., leptospirosis

  • Slips, trips and fall hazards

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

  • Working at heights

  • Working in hot or cold environments

  • Working remote or isolated work

Section 2 - Injury / Illness Information

  • 1. Have any injuries occurred in the past year? (note: this includes minor injuries such as cuts)

  • 1.a) What are the most common causes of injury/illness at your worksite?

  • 1.b) Will MADEC labour hire/seasonal workers be working in the areas where there are high rates of injury/illness?

  • Describe these areas

Section 3 - WHS Systems & Processes - Mandatory Criteria

  • 1. Is there a process in place to proactively identify hazards in the workplace e.g., regular workplace inspections, risk assessments, hazard reports, pre-start checks? TIP: Explain this process, and take a photo, or request a copy of completed workplace inspections, task risk assessments, hazard report form and/or pre-start check as evidence.

  • 2. Are there written safe work procedures/safe work method statements or other measures that describes how jobs should be done to ensure safety, and workers are instructed and trained on these? (Note: SWPs should be prepared for tasks such as safe knife use, operating a tractor, operating plant and equipment). TIP: view safe work procedures that are applicable to the work your workers will perform. Take a photo of these procedures or request copies.

  • 2.a) Do the safe work procedures include visual aids to assist workers with literacy barriers and those from culturally and linguistically diverse backgrounds?

  • NOTE: if high risk construction work is carried out, a safe work method statement must be prepared before work is carried out

  • 3. Is there a process in place to prevent and respond to inappropriate workplace behaviours e.g. bullying, sexual harassment, aggression, violence, under the influence of alcohol and other drugs? TIP: Explain this process and take a photo, or request a copy of the standards of behaviour as evidence.

  • 4. Is there a process in place to regularly (e.g., weekly/monthly) consult (talk and get feedback) with workers on health and safety? e.g. via toolbox talks TIP: Explain this process, and take a photo, or request a copy of a completed toolbox talk or meeting minutes where workers are involved in health and safety discussions as evidence.

  • 5. Has an emergency plan been prepared for the worksite and includes response procedures for the different types of emergencies that could occur? TIP: take a photo of the site emergency plan, or explain in the notes the types of emergencies covered by the plan, and how this information is provided to workers.

  • 6. Are workers provided with a site-specific WHS induction prior to commencing work? TIP: Explain how the induction is delivered to workers, and take a photo of the induction content and/or induction record identifying the content, or explain in the notes what is covered in the induction.

  • 6. a) Explain how you check that the workers understand the information that has been provided to them.

Outcome

  • If you have answered “no” to any of the above mandatory criteria you must seek authorisation from CEO and/or the Relevant Leadership Team member before the placement of workers.

  • Is all mandatory WHS criteria satisfied?

  • Report to MADEC labour hire senior leader for next steps.

  • Proceed with the Site Assessment

Section 4. Site Assessment

  • Location of the worksite
  • Date of site assessment

General housekeeping and environment

  • 1. Do MADEC workers have access to adequate amenities and facilities? i.e., access to shade during breaks, somewhere to eat their food away from workplace hazards, food storage, drinking water, toilets, and handwashing facilities during work. TIP: take a photo of the facilities, or explain in the notes what you observed at the time of the visit. NOTE: Where work is carried out in the field, describe in the notes the amenities that are provided, and how workers can easily access these.

  • Explain how workers in the field have convenient access to amenities and facilities such as chariots or vans equipped with containers of water, portable toilets, and shaded areas for taking work breaks.

  • 2. Is there adequate lighting and ventilation to safely perform the work? TIP: take a photo of the work areas where MADEC workers will be working, or explain in the notes what you observed at the time of the visit.

  • 3. Are floors, stairs, and surfaces designed, installed, and maintained for the tasks being undertaken, and do not present a risk to health and safety? TIP: take a photo of floor surfaces, and stairs, or explain in the notes what was observed at the time of the visit.

  • 4. Are the risks associated with extreme temperatures effectively controlled? Please consider the work tasks performed, the working environment, and the temperature when assessing the controls in place. TIP: take a photo of temperature controls used at the site e.g., chariots for workers to sit under during breaks, industrial fans in packing sheds. Explain these controls in the notes.

  • 5. Are first aid kits available at the workplace, including in work vehicles, and suitably trained first aiders on all shifts (provide details of first aid arrangements)? TIP: take a photo of first aid kits in vehicles and in the workplace, or explain in the notes where kits are located, and the type of kits available e.g. snake bite kits (where there is a risk of snake bite incidents)

Information and Instruction

  • 6. Is signage displayed to indicate the location of the emergency assembly point and first aid kits? TIP: take a photo of the emergency assembly point, and first aid signage.

  • 7. What guidance do you offer to employees regarding hygiene measures in the workplace to prevent infections related to injuries?

  • 8. Where is the nearest medical clinic/facility? TIP: provide the name and location of the nearest medical facility.

  • 9. Are workers provided with information on an Employee Assistance Program and/or mental health support contact details? TIP: take a photo of the EAP or mental health support contact information provided to workers, or explain in the notes how workers are informed of mental health support available to them.

  • Inform the client that MADEC has resources it can provide for this purpose. These can be accessed by the Account Manager via the intranet.

Section 5. Worksite Hazard Management

Plant + Mobile Plant + Vehicles

  • 1. Will MADEC workers be interacting with plant and machinery in the workplace? TIP: If yes, describe in the notes the type of plant and equipment workers will be interacting with.

  • 1. a) What safety measures have been implemented to ensure that the equipment is safe for workers to work with and be around? e.g., maintenance routine, pre-start checks, guarding, emergency stop buttons

  • 1. b) Will MADEC workers be operating any plant or machinery?

  • 1. b) i) Explain how the host ensures MADEC workers are adequately trained and instructed on how to safely operate the plant and machinery. e.g., through practical assessments, maintaining training records, seeking feedback from workers, and observing their performance during tasks.

  • 2. Will MADEC workers be expected to operate equipment that requires a High Risk Work License? i.e., forklift license. If yes, detail in the notes what equipment this is.

  • 2. a) Do existing MADEC workers, who operate equipment requiring a High Risk Work License, hold the appropriate license? TIP: If yes, take a photo of the workers High Risk Work License.

  • Instruct MADEC worker to immediately cease operating the equipment, and notify the MADEC Chief Operating Officer, and/or the HR Manager.

  • 3. During their time at the workplace, will MADEC workers be exposed to mobile plant, such as forklifts, and other traffic, such as trucks, even when they are taking breaks, accessing toilets, meal rooms, office areas, etc.?

  • 3. a) Is there a documented traffic management plan in place, and various traffic management controls implemented, such as physical bollards, line marking, gates, warning alarms, and speed limits? TIP: take a photo of the traffic management plan document, and traffic management controls used at the site or explain in the notes what you observed at the time

  • 4. Are quad bikes or side-by-side vehicles (SSVs) present at the site? Note: this includes ATVs, RTVs and UTVs.

  • 4. a) Are quad bikes / SSVs securely stored to avoid unintended access? TIP: take a photo of the quad bikes being safely stored, such as with the keys removed from the ignition and placed in a locked cabinet, or explain in the notes what you observed at the time of the visit.

  • 5. If the site has quad bikes or Side-by-Side Vehicles (SSVs), and MADEC workers are required to operate these vehicles as indicated in the JSA, then proceed with the necessary safety checks below. TIP: Take a photo of each control and add it to the media section of the check, to verify it is present.

  • 5. a) Safe Work Procedure available and accessible at the worksite

  • 5. b) Records of training and competency kept at the worksite

  • 5. c) Start-up checks are completed before every use and records are available at the worksite

  • 5. d) Vehicle fitted with an operator protective device (OPD)

  • 5. e) Adequate PPE is available at the worksite including helmets that conform to Australian Standards, eye protection sturdy boots, gloves, long sleeves and trousers.

  • 5. f) No go zones are signposted.

  • 5. g) Speed limits are set and signposted.

  • 5. h) Have all the above quad bike or SSV safety checks been verified?

  • DO NOT allow MADEC workers to operate the vehicle until all required controls have been implemented by the client and verified by MADEC.

Manual Tasks

  • 6. What measures have you implemented to minimise the risks associated with manual tasks? e.g., work area design and layout, availability of mechanical aides, adherence to weight limits, ensuring comfortable working surface heights, job rotation, and introducing variety to reduce repetition and static postures. TIP: take a photo of any aides used to control the risk, or explain in the notes what you observed at the time of the visit.

Tools, Equipment + Knives

  • 7. What specific guidelines do you give to workers regarding the secure storage of knives when they are not being used?

Hazardous Chemicals

  • 8. Will any MADEC workers be exposed to hazardous chemicals while at work? Tip: Consider all hazardous chemicals that are used at the workplace, that could be applied to products or materials that workers are exposed to.

  • 8. a) Do you maintain a register of all hazardous chemicals and are Safety Data Sheets available for hazardous chemicals workers are exposed to? TIP: take a photo of the hazardous chemicals register, and a sample of Safety Data Sheets, or explain in the notes where the register and Safety Data Sheets are located, and if they are accessible to workers.

  • 8. b) Do you have an eye wash shower and is it easily accessible to workers who may be exposed to chemical burns? TIP: take a photo of the location of the eye wash shower, or explain in the notes where this is located.

Working at Heights

  • 9. Will any MADEC workers be required to work at heights where there is a risk of fall?

  • 9. a) Are specific control measures are in place to manage the risks associated with falls? i.e., temporary work platforms, guardrails, fall arrest systems, etc. TIP: take a photo of the work areas where workers will need to work at heights, and the controls in place to prevent falls e.g., guardrails, or explain in the notes what you observed at the time of the visit.

Confined Space

  • 10. Will any MADEC workers be required to work in confined spaces? Note: A confined space in refers to an enclosed or partially enclosed space not primarily for human occupancy, at atmospheric pressure, that poses risks due to harmful airborne contaminants, unsafe oxygen levels, or engulfment. These typically include pits, silos, vats, pipes, and tanks.

  • 10. a) Are confined space entry permits required for entry? TIP: take a photo of the confined space risk controls e.g., confined space entry permit, atmospheric monitoring equipment, training records, or explain in the notes what you observed at the time of the visit.

  • 10. b) Do MADEC workers need to complete confined space training before they are allowed to perform such work?

Electrical + Powerlines

  • 11. What electrical equipment and appliances will MADEC workers interact with in the workplace?

  • 11. a) Does electrical equipment appear to be in good condition? TIP: take a photo of the electrical equipment and leads in the working areas where workers will be performing tasks, as well as a picture of the tag indicating the date of the last test and the date of the next scheduled test, or explain in the notes what you observed at the time of the visit.

  • 12. Are there any overhead powerlines that MADEC workers may be exposed to anywhere on the property, posing potential risks?

  • 12. a) Is there a process in place to ensure a safe distance from powerlines is maintained (i.e. exclusion zones, markers on powerlines, site map of powerlines)? TIP: take a photo of the powerline site map and the risk controls in place to prevent contact with powerlines, or explain in the notes what you observed at the time of the visit.

Falling Objects

  • 13. Is there a risk of objects falling from height and injuring a MADEC worker?

  • 13. a) Are loads secured to prevent them from falling from one level to another e.g., isolation/no-go zones, fall prevention, fall arrest systems, PPE, signage? TIP: take a photo of objects stored at height that could potentially fall on a worker, and the risk controls in place to prevent the fall e.g., secure racking systems, netting, restraining bars, or explain in the notes what you observed at the time of the visit.

Validation of Risk Control Measures

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

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

Next Review

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

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

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

Summary

  • Will MADEC proceed with placement?

  • Explain the reasons why MADEC will not proceed with placement

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.