• Document No.

  • Work Location

  • Conducted on

  • Staff Involved in Assessment


  • 1.0 Is signage correct and positioned in clear view of workers and the public?

  • 2.0 Are chemicals secured and labelled correctly?

  • 3.0 Is correct mopping technique being applied?

  • 4.0 Is PPE supplied and being used appropriately?

  • 5.0 Has a compliance check been conducted on mechanical aides?

  • 6.0 Is correct manpower being utilised during trolley movement?<br><br> - 2 persons for large dirty linen<br> - 1 for small dirty linen <br> - 1 for clean linen<br> - 2 for bed move or powered bed mover

  • 7.0 Are power cables secured so they are not causing a trip hazard?

  • 8.0 Is a suitable step stool or ladder being utilised for work at higher than normal reach levels?

  • 9.0 Has the "below the elbow" policy been adhered to?<br><br> - No bracelets, wrist watches, rings (a single flat band is ok)<br> - Are sleeves above the elbow?<br> - Are nails short and clean, no nail polish or artificial nails?<br> - Has broken skin (cuts, dermatitis or abrasion) been covered with a waterproof film dressing?<br> - No long ties and lanyards. Use the retractable (or similar) ID card holders

  • Sign Off By Safety and Wellbeing Staff Member

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