• DSE Assessment Record

  • Assessment
  • Select work department

  • Enter Employee Name

  • Enter Employee Pay Roll Number

Lighting

  • Is the lighting at your usual workstation adequate?

  • Are there distracting reflections on your screen?

  • Describe the issue.

  • Take a photo if possible to show the issue.

  • Do you have control over local lighting?

Temperature & Humidity

  • Are you usually comfortable at your workstation?

  • Is the air around your workstation:

  • Describe what the issue is that is making you uncomfortable.

Noise

  • Is the noise from other work equipment acceptable?

  • Describe the issues experienced.

  • Take photos of equipment generating the noise issue.

Space

  • Is there enough space around your workstation?

  • Describe the issue.

  • Take a picture of the desk area.

Chair

  • Is the seat height adjustable?

  • Is the angle and height of the backrest adjustable?

  • Is the chair stable?

  • Is the chair in a good state of repair?

  • Describe the what is wrong with the chair.

  • Take a photo of the chair.

  • Does the chair have arms?

  • Are the arms free from issues involving the workstation?

  • Describe the issues that the arm are causing.

  • Take a photo of the issue that the arms are causing.

  • Is the chair comfortable?

  • Describe the issues with the chair.

Desk

  • Is the desk surface large enough?

  • Take a picture of the working area.

  • Is the height of the desk suitable?

  • Describe the issues with the desk height i.e. Too high, Too low etc.

  • Take a picture.

  • Is the desk height suitable so that a foot rest is not required?

  • Has a foot rest been provided?

Document Holder

  • Do you require a document holder?

  • Has a document holder been provided?

  • Can you adjust your document holder to the right angle?

Display Screen and Keyboard

  • Is there a brightness control on your screen?

  • Is there sufficient difference between characters and background?

  • Is the screen image stable and free from flicker?

  • Is the computer a Desktop or Laptop?

  • Does your screen move freely?

  • Describe what is wrong with the item.

  • Take a picture of the issue.

  • Is the screen at a comfortable height for you?

  • Describe what is wrong with the item.

  • Take a picture of the issue.

  • Is the keyboard height adjustable?

  • Describe what is wrong with the item.

  • Take a picture of the issue.

  • Are the symbols on the keys easily visible?

  • Describe what is wrong with the item.

  • Take a picture of the issue.

  • Is there sufficient space in front of the keyboard to rest operators hands?

  • Are operators forearms parallel to the work surface?

  • Describe what is wrong with the item.

  • Take a picture of the issue.

  • Is the operators wrists comfortable?

  • Describe what is wrong with the item.

  • Take a picture of the issue.

  • Are the symbols on the keys easily visible?

  • Describe what is wrong with the item.

  • Take a picture of the issue.

  • Is there sufficient space in front of the keyboard to rest operators hands?

  • Are operators forearms parallel to the work surface?

  • Describe what is wrong with the item.

  • Take a picture of the issue.

  • Is the operators wrists comfortable?

  • Describe what is wrong with the item.

  • Take a picture of the issue.

Other Equipment

  • Is your phone located conveniently?

  • Describe the issues.

  • Take a picture.

  • Is there enough space to load paper into printers and copiers?

  • Describe the issues.

  • Take a picture.

  • Can you easily access shelf's above or below the workstation?

  • Describe the issues.

  • Take a picture.

  • Is all other equipment satisfactory?

  • Describe the issues.

  • Take a picture.

Training

  • Have you been trained in how to set up your workstation so it is comfortable?

  • Have you been trained in how to use your software?

  • Do you understand how to use your software?

  • Enter a date when training needs to be completed by.

  • Do you know who to contact if there is an issue with your workstation?

  • Do you know the company arrangements for eye tests?

  • Signature:

  • Insert date of assessment

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