Office Ergonomics Assessment

• Site conducted

  Select

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Overview

• Add media

  Media

• undefined

Seating

• Is the chair vertically adjustable and on a five-point base?

  Yes

  No

  N/A

• Does the chair have an adjustable lumbar (low back) support?

  Yes

  No

  N/A

• Does the backrest provide adequate support for your back?

  Yes

  No

  N/A

• Does the seat pan width and depth provide for good fit and comfort?

  Yes

  No

  N/A

• Does the seat pan have tilt adjustability?

  Yes

  No

  N/A

• Does the seat pan have depth (forward and backward) adjustability?

  Yes

  No

  N/A

• Does the seat pan have a rounded front that does not pressure the back of your knees and legs?

  Yes

  No

  N/A

• When seated, are knees at or below the level of your hips (knees not higher than hips)?

  Yes

  No

  N/A

• Is there a foot rest flat on floor and supportive?

  Yes

  No

  N/A

• Does the chair have armrests that support the forearms and do not interfere with swivel or normal movements of the chair?

  Yes

  No

  N/A

Keyboard & Mouse

• Does the keyboard location allow you to keep the upper arms and elbows close to the body (arms not extended outward beyond 45 degrees)?

  Yes

  No

  N/A

• Is there weight bearing support for the arms (chair arms or wrist rest) when using the keyboard?

  Yes

  No

  N/A

• Does the keyboard position and angle allow for a neutral wrist posture so hands are in a straight line with forearms (not bent up/down or sideways toward little finger)?

  Yes

  No

  N/A

• Does the mouse location allow employee to keep their upper arm and elbow close to body (arm not extended outward beyond 45 degrees)?

  Yes

  No

  N/A

• Is there weight bearing support for their arms (chair arm or wrist rest) when using your mouse?

  Yes

  No

  N/A

• Does the placement of the mouse allow for a neutral wrist posture so hands are in a straight line with forearm (not bent up/down or sideways toward little finger)?

  Yes

  No

  N/A

• Do employees arms and wrists rest upon surface areas (arm rests, wrist rests, desktop) absent from any sharp or hard edges?

  Yes

  No

  N/A

Monitor

• Is the screen directly in front of employees (no twisting of your head and neck)?

  Yes

  No

  N/A

• Is the top line of screen at or slightly (0-30 degrees) below eye level?

  Yes

  No

  N/A

• Is the monitor located at least arm's length away?

  Yes

  No

  N/A

• Can employees clearly read the screen without bending head, neck or trunk forward/backward?

  Yes

  No

  N/A

• Is the monitor in a location that eliminates glare on the screen which might cause employees to assume an awkward position to read screen? (Answer "no" if there is any glare on your screen)

  Yes

  No

  N/A

• Is the screen placed at right angles away from windows and task lights to avoid glare and bright light directly behind the screen?

  Yes

  No

  N/A

Other

• Is there adequate desktop space available to perform job tasks without twisting, side vending, or reaching?

  Yes

  No

  N/A

• Is there enough clearance for employees feet, knees, and legs?

  Yes

  No

  N/A

• Is there adequate space that allows employees to swivel their chair (without leg obstruction) to perform work tasks?

  Yes

  No

  N/A

• If employees job requires frequent telephone use, is a headset provided to use when phone communication is combined with hand tasks such as typing and writing?

  Yes

  No

  N/A

• If employees job requires frequent viewing of documents, is a document holder provided to hold documents in a vertical position?

  Yes

  No

  N/A

• Is the document holder (if provided) placed at about the same height and distance as monitor screen?

  Yes

  No

  N/A

• Add signature

  Sign