Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Section 1 Size and layout of the workplace
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Is the area / size of workplace recorded?
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Detail workplace area / size here:
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What is the maximum distance to first aid?
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Enter the maximum distance to first aid and means of getting there:
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How many floors in building?
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Enter number of floors in building here:
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What is the access between floors?
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Detail the available means of access here:
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What are the workplace physical considerations for example, sealed or unsealed roads etc.
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Detail workplace physical conditions here:
Section 2 Number and distribution of workers
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What group does the number of staff fall into A , B or C . Refer to Table 1.1 below<br>
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Table 1.1
Group Definition Requirements
A: 100 or more workers or high risk workplace with 25 or more workers Workplaces other than high risk – at least one first aid kit for first 50 workers; two kits for 100 and one additional kit for every 100 workers thereafter. At least one first aid officer for 25 to 50 workers, two first aid officers for 51 to 100 workers and an additional first aid officer for every additional 100 workers.
High risk workplace – at least one first aid kit for first 25 workers and one additional kit for every 50 workers thereafter. At least one first aid officer for up to 25 workers, two first aid officers for 25 to 50 workers and an additional first aid officer for every additional 50 workers.
B: More than 10, fewer than 100 workers or high risk workplace with less than 25 workers Workplaces other than high risk – at least one first aid kit to be provided for workers. At least one first aid officer for 25 to 50 workers, two first aid officers for 51 to 100 workers and an additional first aid officer for every additional 100 workers.
High risk workplace – at least one first aid kit for first 25 workers and one additional kit for every 50 workers thereafter. At least one first aid officer for up to 25 workers, two first aid officers for 25 to 50 workers and an additional first aid officer for every additional 50 workers.
C: 10 or less workers At least one first aid kit to be provided for workers. Risk assessment conducted to identify the need to provide a first aid officer. -
What types and number of shifts are worked?
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Enter shift details here:
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What overtime is worked, for example are workers working more than normal base hours?
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Enter details of working hours here:
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Are any workers working in isolated or remote areas?
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Enter details of communication plan in place and access to first aid here:
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Are members of the public present?
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Enter arrangements in place for the public here:
Section 3 Nature of hazards and severity of risks
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Have the known hazards which would need specific first aid requirements been identified and documented? for example falling from height, hazardous substance exposure etc.
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Enter details of known hazards here and check that they are included in the WRA:
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Have the types and likelihood of injuries possible for example, bleeding from wounds, shock reaction to crush injury, head or spinal injuries from falls, exacerbation of heart related conditions, fractures or dislocations or soft tissue injuries from equipment use, environment exposure (hot or cold), hazardous substances burns, prior medical conditions such as epilepsy, asthma and diabetes been identified?
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List the types and likelihood of possible injuries here:
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Do SDS’s / product data sheets or product labels specify first aid requirements?
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List details here:
Section 4 Location of the workplace
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Has the nearest hospital been identified and details posted?
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List travel time here: Are hospital details posted on site?
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Post photograph of plan here:
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Has the nearest medical or occupational health service been identified and spoken to re our works?
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List travel time here: Are medical or occupational health service details posted on site?
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Detail these arrangements here
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Post photograph of plan here:
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Access / egress arrangements for emergency services, including security considerations
Section 5 Known occurrences of incidents and illnesses
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Have the known occurrences of incidents and illnesses in the last 12 months been recorded?
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Check three records and enter details here:
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Is incident data being documented as per JH requirements?
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Check three records and enter details here:
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Are near misses being recorded?
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Check three records and enter details here:
Section 6 Other
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Are automatic external defibrillators (AEDs) required for this workplace?
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If no, provide details on decision not to have one:
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Is specialist emergency equipment required for this workplace? for example stokes litter, rescue equipment etc.
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List specialist equipment here:
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Are specialist medical personnel required for this workplace? for example a nurse or paramedic
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Provide reasoning for decision:
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Any additional miscellaneous items?
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Provide detail:
