Information
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Document No.
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Client / Site
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Address
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Client Contact Name & Position
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Conducted on
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Prepared by
Systems / Policies / Contacts
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Name of Person/s responsible for WHS onsite<br>(List Name & Location)<br>
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Does the client have a documented WHS Management Plan?
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Does the client have an Injury management policy/program?
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Does the client have a Risk Management Program or Workplace Inspection Schedule in place?
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Does the client have Hazard / Incident reporting forms or processes (EG Accident, Injury, Near Miss Forms or reporting methods)
Consultation / Training
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Does the client have WHS consultation arrangements in place? EG OHS Committee / HSR / meetings / Toolbox Talks (If yes list type & frequency below)
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If OHS Committee is in place are minutes of meetings available to staff? (Sight if possible & list location below)
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Are on hired staff put through client in house induction / training as well as Exact's induction? (If yes sight induction, list location & details below)
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Does the client have documented Safe Work Procedures (SWP) / Safe Work Method Statements (SWMS) or Work Instructions?
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Will on hired staff be trained / monitored & supervised at all times? (If yes please list by whom & contact details for that person)
Injury / Incident / First Aid
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Is there a dedicated client contact for Exact who will report Injuries / Incidents or general feedback on our candidates? (If yes please list name & direct contact number)
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Is there a person / persons trained in First Aid onsite? (If yes list name & location)
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Is there an efficiently stocked First Aid Kit or Kits available onsite? *Must be within a reasonable distance of where on hired staff are working (If yes please list location below)
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Are First Aid Kits checked / serviced / maintained / refilled on a regular basis? (If yes list frequency & by whom)
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Is there a First Aid register onsite for recording injuries / illnesses? (If yes please list location)
Amenities
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Are there adequate toilets for males and females within close proximity of working area?
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Are toilets clean and well stocked with toilet paper & soap?
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Is there a safe area for storing personal belongings? (If yes & not at desk please list location)
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Is there a dedicated lunchroom / kitchen for on hired staff to use during breaks?
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Are facilities for storing / heating food available (EG Fridge / Microwave / Kettle ETC) - Please list items below
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Emergency Provisions (Inc Fire)
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Is there a building evacuation plan displayed? (If yes list location / locations closest to on hired staff location)
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Are clients emergency procedures & muster / assembly points available or displayed? (If yes list location)
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Are evacuation drills conducted and how often? (Please list)
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Are emergency telephone numbers displayed? ( If yes please list location)
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Do all emergency exits open outwards and are kept unlocked?
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Are all emergency exits clear of obstructions both inside and out?
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Are all emergency exits clearly marked? (Lights working /visible)
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Is there sufficient fire fighting equipment within close proximity of working area?
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Are fire extinguishers / hoses & blankets stored with clear access and signage?
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Are fire extinguishers / hoses and blankets tested and tagged every six months? (If yes please list last tag date)
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Electrical
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Are all plugs / sockets / switches and leads in good condition? (ie: Not damaged, frayed or exposed wires showing)
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Is electrical equipment / leads tested and tagged? (If yes list last tag date)
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Are all electrical leads and wires organized in a neat orderly fashion so as to eliminate tripping hazard?
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Workstation
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Is the work desk at a good height and has an adjustable chair to be able perform work duties in correct posture?
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Are chairs clean & in good working order? (Eg height adjustable levers working, wheel rollers in good working order etc)
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Is there sufficient leg room under the desk?
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Is monitor at correct height or adjustable?
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Is monitor approximately an arm's length away?
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Is monitor free of glare and reflections?
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Is the keyboard and mouse within easy reach for keying & computer tasks?
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Is the phone or other frequently used items positioned within easy reach?
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If there is considerable phone work, Is or can a headset be provided?
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Are filing cabinets in good working order?
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Is there adequate storage for folders, files and paperwork?
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Are there opportunities for regular changes in posture throughout the day? (Please list frequency or other tasks below)
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Is there adequate light for work to be performed?
Other Office Hazards
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Is background noise at a level where work can be performed with adequate concentration?
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Is office area air conditioned / climate controlled and set at a comfortable level (between 20-26 degrees)?
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Are air conditioner regularly serviced?
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Will on hired staff avoid lifting heavy / bulky or awkward items? (Heavy = What a person is capable of OR no more than 5kg seated or 15kg in other positions)
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Are most commonly used items in storage areas between shoulder to mid thigh level?<br>
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Is there appropriate equipment available for accessing high shelving? (EG safety steps)
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Is there asbestos in the worksite? (does not apply to buildings constructed after 31/12/2003). *If YES please list the location of the asbestos register below
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Are there requirements for on hired staff to work in isolation or remotely from other staff / workforce?
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If yes are adequate arrangements in place for emergency communication that are reliable? (please list below)
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Apart from general kitchen cleaning products are there any other chemicals stored onsite? (EG Paint thinners / mentholated spirits)
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If yes are those chemicals stored in there correct containers & are MSDS / SDS available for those chemicals? (Please list location of MSDS)
Signatures
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Client Company Representative
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Person Whom Completed Workplace Safety Assessment