Title Page
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Site conducted
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undefined
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Date
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Company
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Contractor name
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DBS approved, please note if not or cannot provide any evidence the contractor must be supervised and escorted while on St Clare's property
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what evidence has been seen,
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Number of people working with lead contact
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Area, please state the location you are working at St Clare's
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Work: please state what work you are undertaking
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Expected finish time
Emergencies and House parent accommodation arrangements
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Emergencies: Alarm sounds, stop what you are doing. Make the area safe and head to the designated assembly point and make sure your contact at St Clare's nose that you are present.
House parent accommodation: It must be arranged 24 hours before your arrival if you need to enter a house parent accommodation, your contact at St Clare's should have done this prior to your arrival. If at any point you need to enter the house parent accommodation you must knock and wait to be let in. If no one answers the house parent accommodation is door please phone or visit your contact St Clare's to assist you.
The risk assessment
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If at any point during your time while working at St Clare's on any of the below risks please comment in associated boxes.
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Height
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If yes please state you activity
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Asbestos
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If yes please state you activity
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Kitchen
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If yes please state you activity
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Laboratories
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If yes please state you activity
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Transport
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If yes please state you activity
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Cables or power
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If yes please state you activity
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Hot work (note a hot work permit must be attained if working on hot work)
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If yes please state you activity
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Noise
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If yes please state you activity
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Protective clothing and PPE
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If yes please state you activity
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Student interface
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If yes please state you activity
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CoSHH will you be using substances, contractor substances, working with fumes, dust, paint thinners, cleaning products etc
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If yes please state you activity
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Electrical
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Will you at any point be isolation/locking off/cable routes/testing/underground services/power lines at Hight, for 110v/240v/410v
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Gas, water
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Will you at any point be turning off or isolating gas appliances, underground services, working on pipe routes, cylinders, acetylene, oxygen, LPG etc.
Signature
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Leaving the site
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(Same day) If you have to leave site for any reason, it is expected that you will do a reasonable risk assessment on your return. If anything has changed, any way increases risk of any type - you must inform your St Clare's contact immediately.
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Important
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Please read this contents & if you agree with the statement,
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On behalf of myself and those working with me or under my guidance, I/we have been involved in this risk assessment. The St Clare's representative has explained relevant hazards and informed me/us of areas or processes that may contribute a risk. I and others under my authority firm that I/we shall abide by industry 'best practice' for our trade and will comply with all the relevant risk management rules and procedures designed to keep St Clare's staff, students and all others in a safe working environment.
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Contractor full Name and signature
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Email address
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St Clare's staff and point of contact Full Name signature
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St Clare's staff contact phone number
