Information

  • Document No.

  • Client / Site

  • Address

  • Client Contact Name & Position

  • Conducted on

  • Prepared by

Systems / Policies / Contacts

  • Name of Person/s responsible for WHS onsite<br>(List Name & Location)<br>

  • Does the client have a documented WHS Management Plan?

  • Does the client have an Injury management policy/program?

  • Does the client have a Risk Management Program or Workplace Inspection Schedule in place?

  • Does the client have Hazard / Incident reporting forms or processes (EG Accident, Injury, Near Miss Forms or reporting methods)

Consultation / Training

  • Does the client have WHS consultation arrangements in place? EG OHS Committee / HSR / meetings / Toolbox Talks (If yes list type & frequency below)

  • If OHS Committee is in place are minutes of meetings available to staff? (Sight if possible & list location below)

  • 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)

  • Add media

  • Does the client have documented Safe Work Procedures (SWP) / Safe Work Method Statements (SWMS) or Work Instructions?

  • 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

  • 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)

  • Is there a person / persons trained in First Aid onsite? (If yes list name & location)

  • 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)

  • Is there a First Aid register onsite for recording injuries / illnesses? (If yes please list location)

Amenities

  • 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)

  • Add media

  • Is there a dedicated lunchroom / kitchen for on hired staff to use during breaks?

  • Add media

  • Are facilities for storing / heating food available (EG Fridge / Microwave / Kettle ETC) - Please list items below

  • Add media

Emergency Provisions (Inc Fire)

  • Is there a building evacuation plan displayed? (If yes list location / locations closest to on hired staff location)

  • Add media

  • 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)

  • Are emergency telephone numbers displayed? ( If yes please list location)

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  • Do all emergency exits open outwards and are kept unlocked?

  • Are all emergency exits clear of obstructions both inside and out?

  • Are all emergency exits clearly marked? (Lights working /visible)

  • Is there sufficient fire fighting equipment within close proximity of working area?

  • 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

  • Are all plugs / sockets / switches and leads in good condition? (ie: Not damaged, frayed or exposed wires showing)

  • Is electrical equipment / leads tested and tagged? (If yes list last tag date)

  • Are all electrical leads and wires organized in a neat orderly fashion so as to eliminate tripping hazard?

  • Add media

Workstation

  • Is the work desk at a good height and has an adjustable chair to be able perform work duties in correct posture?

  • Add media

  • 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?

  • Is monitor at correct height or adjustable?

  • Is monitor approximately an arm's length away?

  • Is monitor free of glare and reflections?

  • Is the keyboard and mouse within easy reach for keying & computer tasks?

  • Is the phone or other frequently used items positioned within easy reach?

  • If there is considerable phone work, Is or can a headset be provided?

  • Are filing cabinets in good working order?

  • Is there adequate storage for folders, files and paperwork?

  • Are there opportunities for regular changes in posture throughout the day? (Please list frequency or other tasks below)

  • Is there adequate light for work to be performed?

Other Office Hazards

  • Is background noise at a level where work can be performed with adequate concentration?

  • Is office area air conditioned / climate controlled and set at a comfortable level (between 20-26 degrees)?

  • Are air conditioner regularly serviced?

  • 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)

  • Are most commonly used items in storage areas between shoulder to mid thigh level?<br>

  • Is there appropriate equipment available for accessing high shelving? (EG safety steps)

  • Add media

  • 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

  • Are there requirements for on hired staff to work in isolation or remotely from other staff / workforce?

  • If yes are adequate arrangements in place for emergency communication that are reliable? (please list below)

  • Apart from general kitchen cleaning products are there any other chemicals stored onsite? (EG Paint thinners / mentholated spirits)

  • If yes are those chemicals stored in there correct containers & are MSDS / SDS available for those chemicals? (Please list location of MSDS)

Signatures

  • Client Company Representative

  • Person Whom Completed Workplace Safety Assessment

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.