Pre Deployment Assessment: Blue Collar

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Business

• Business purpose? (what does the business do)

• Senior site representative? (name, title, phone, email)

• Can we receive a copy of the organisation chart?

  Yes - supplied

  Yes - to be supplied

  No - not available

  No

• Number of workers at site?

• Blue/ white collar quantities?

• Core/ major classifications/ roles in the business?

• Permanent/ Non permanent quantities?

• Are there position descriptions available for all classifications/ roles? (list relevant classifications/roles)

  Yes

  No

  N/A

• Can we receive copies of relevant position descriptions?

  Yes - supplied

  Yes - to be supplied

  No

Key Business Representatives

• Who is the WHS Manager or equivalent representative? (name, title, phone, email)

• Who is the WHS Officer(s)? (name, title, phone, email)

• Who is the Return to Work Coordinator? (name, title, phone, email)

• Who is the Payroll Coordinator? (name, title, phone, email)

• Who is the Accounts Payable Coordinator? (name, title, phone, email)

WHS System

• Is there a working WHS system for the site?<br>If "Yes", what is the name of the system. <br>If "No", how does the business manage site safety?

  Yes

  No

  N/A

• Does the business review and update the WHS system to meet relevant legislative and industry requirements?

  Yes

  No

  N/A

• Does the business conduct external audits of the WHS system?<br>If "Yes", how regularly?

  Yes

  No

  N/A

WHS Commitment

• Are ALL workers subject to the same conditions of the site WHS system, procedures and processes?

  Yes

  No

  N/A

Site Safety Induction

• Does the business undertake site safety and orientation inductions for new workers? <br>If "No", how does the business orientate new workers?

  Yes

  No

  N/A

• Can we receive a copy of the induction documents/ tool?

  Yes - supplied

  Yes - to be supplied

  No

• Is the induction formal or informal?

  Formal

  Informal

• What day and time is the site safety induction conducted?

• Induction duration?

  30 mins or less

  30 mins - 1hr

  1 hr - 2 hrs

  more than 2 hours

• Who conducts the site safety and orientation inductions?

  WHS representative

  Training representative

  Administration representative

  Workshop representative

  Other

• Inductor details? (name, title, phone, email)

Site Safety Induction: Content

• Business purpose?

  Yes

  No

  N/A

• Key Business Policies?

  Yes

  No

  N/A

• WHS management philosophies?

  Yes

  No

  N/A

• WHS management tools? (risk assessments, lock out/ tag out procedures, etc)

  Yes

  No

  N/A

• Evacuation procedure?

  Yes

  No

  N/A

• Incident/ accident reporting procedure?

  Yes

  No

  N/A

• PPE requirements?

  Yes

  No

  N/A

• Identifies WHS representatives?

  Yes

  No

  N/A

• Identifies first aid representatives?

  Yes

  No

  N/A

• Guided site tour?

  Yes

  No

  N/A

• Do inductees complete an induction assessment?

  Yes

  No

Risk Management

• Does the business conduct site-related risk assessments?

  Yes

  No

  N/A

• Does the business conduct role &/ or task-related risk assessments?<br>If "No", how does the business satisfy WHS risk management legislation?

  Yes

  No

  N/A

• How does the business ensure that high risk work is conducted by appropriately qualified workers?

• Does the business have documented procedures for the following:

• Confined space?

  Yes

  No

  N/A

• Working at heights?

  Yes

  No

  N/A

• Manual handling?

  Yes

  No

  N/A

• Hazardous substances?

  Yes

  No

  N/A

Risk Management: Tools

• Does the business have current risk assessments for ALL common or typical tasks?

  Yes

  No

  N/A

• Tools Used:

• Pre Start Checks? (machinery, plant/ vehicles, power tools)

  Yes

  No

  N/A

• Safe Operating Procedures? (SOP)

  Yes

  No

  N/A

• Safe Work Method Statement? (SWMS)

  Yes

  No

  N/A

• Job Safety Assessment? (JSA)

  Yes

  No

  N/A

• Safe Work Procedure? (SWP)

  Yes

  No

  N/A

• Personal Risk Assessment? (Take 5)

  Yes

  No

  N/A

• How are changes to risk assessment documents/ tools communicated to workers? (list methods)

• Can we receive a copy of the relevant risk assessment tool(s) for issuance to our employee prior to initiating work at the business site?

  Yes - supplied

  Yes - to be supplied

  No - will be issued by business upon worker commencement

  No - not available

  No

Risk Management: Workers

• What level of supervision does the business provide to workers?

  Continuous

  Frequent - Hourly

  Occasional - Every few hours

  Minimal - Once or twice a day

  None

• Do workers participate in risk assessments prior to commencing ALL tasks?

  Yes - it is policy & closely managed

  Probably - it is policy

  Possibly - it is not policy but is expected

  Probably not

  No

• Are risk assessments signed off by participant workers & copies retained by the business?

  Yes/ Yes

  Yes/ No

  No/ Yes

  No/No

• How does the business encourage, coordinate & maintain worker participation in risk assessment?

• How does the business collect and maintain the records of worker licences & tickets?

WHS Consultation

• Does the business consult with the workers?

  Yes

  No

• What is the formal consultation arrangement?

  Safety Officer

  Health Safety Representatives (HSR)

  WHS Committee

• How often do formal WHS meetings occur?

  Select Daily Weekly Fortnightly Monthly Quarterly Annually Other

  • Daily
  • Weekly
  • Fortnightly
  • Monthly
  • Quarterly
  • Annually
  • Other

• If "Other", provide detail.

• Who typically attends WHS meetings? (list attendees)

WHS Communication: how does the business disseminate information?

• Toolbox talks? <br>If "Yes", how regularly do toolbox talks occur?

  Yes

  No

  N/A

• Notice boards? <br>If "Yes", how often are notice boards updated?

  Yes

  No

  N/A

• Newsletters? <br>If "Yes", how often are they distributed?

  Yes

  No

  N/A

• Online - Intranet, email?

  Yes

  No

  N/A

• General meetings?

  Yes

  No

  N/A

• Other? (list detail)

  Yes

  No

  N/A

Workplace Inspections: How does the business undertake WHS inspections?

• Safety Observation?<br>If "Yes", how regularly?

  Yes

  No

  N/A

• Workplace Inspection?<br>If "Yes", how regularly?

  Yes

  No

  N/A

• Internal Audit?<br>If "Yes", how regularly?

  Yes

  No

  N/A

• External Audit?<br>If "Yes", how regularly?

  Yes

  No

  N/A

• Who conducts the internal observations/ inspections/ audits?

  Select Senior Business Representative WHS Manager/Officer Safety Committee Representative HSR worker Randomly selected from the business Other

  • Senior Business Representative
  • WHS Manager/Officer
  • Safety Committee Representative
  • HSR
  • worker
  • Randomly selected from the business
  • Other

• If "Other", provide detail.

• How are identified issues resolved? (ie; reported to WHS committee, authority sought & provided, necessary work completed).

  Yes

  No

  N/A

Injury Statistics: previous 12 months

• Lost time injury (LTI)? <br>If "Yes", list quantity & brief detail for each.

  Yes

  No

  N/A

• Medical treatment injury (MTI)? <br>If "Yes", list quantity & brief detail for each.

  Yes

  No

  N/A

• First aid treatment? <br>If "Yes", list quantity.

  Yes

  No

  N/A

• Near miss incidents? <br>If "Yes", list quantity & brief detail for each.

  Yes

  No

  N/A

• Injury Categories.

• Sprains & Strains?<br>If "Yes", quantity

  Yes

  No

  N/A

• Cuts & Abrasions?<br>If "Yes", quantity

  Yes

  No

  N/A

• Eyes?<br>If "Yes", quantity

  Yes

  No

  N/A

• Psychological (bullying, stress)?<br>If "Yes", quantity

  Yes

  No

  N/A

• Other?<br>If "Yes", quantity & brief detail for each.

  Yes

  No

  N/A

Injury Treatment

• Forsythes insist that ALL injuries incurred by our employees are reported to Forsythes immediately. Excluding emergency situations, Forsythes utilise the services of preferred medical service providers for medical treatment injuries.

• Does the business have an injury treatment management plan?

  Yes

  No

  N/A

• Does the business offer return to work suitable duties for ALL workers?

  Yes

  No

  N/A

Incident Reporting

• Does the business have an accident/ incident management plan?

  Yes

  No

  N/A

• How do workers communicate with the business.

• Accident/ Incident report book?

  Yes

  No

  N/A

• Accident/ Incident report form?

  Yes

  No

  N/A

• WHS representative/ Health Safety Representative/ WHS Committee

  Yes

  No

  N/A

• Supervisor/ Team Leader

  Yes

  No

  N/A

• Will the business conduct a collaborative & transparent investigation for accidents/ incidents involving Forsythes workers?

  Yes

  No

  N/A

Site Facilities & Amenities

• Does the business offer the following amenities:

• Lunchroom: fridge, microwave, sufficient seating?<br>If "No", list alternative arrangements.

  Yes

  No

  N/A

• Toilets?<br>If "No", list alternative arrangements.

  Yes

  No

  N/A

• Showers?<br>If "No", list alternative arrangements.

  Yes

  No

  N/A

• Lockers/ personal storage?<br>If "No", list alternative arrangements.

  Yes

  No

  N/A

• First Aid room?<br>If "No", list alternative arrangements.

  Yes

  No

  N/A

• Off street parking?<br>If "No", list alternative arrangements.

  Yes

  No

  N/A

• Smoking area?<br>If " No", list alternative arrangements.

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• Which party will supply the following items.

• Safety footwear (steel cap)?

  Forsythes

  Host Employer/ PCBU/ Not Applicable

• Minimum Standard:

  Lace Up, ankle support

  Lace Up

  Slip On

  No minimum standard

  Other

• If "Other" (detail)

• Shirt?

  Forsythes

  Host Employer/ PCBU/ Not Applicable

• Minimum Standard:

  Select HiVis LS, reflect - yellow/blue HiVis LS, reflect - orange/blue HiVis LS, reflect - rail compliant HiVis LS - yellow/blue HiVis LS - orange/navy HiVis No minimum standard Other

  • HiVis LS, reflect - yellow/blue
  • HiVis LS, reflect - orange/blue
  • HiVis LS, reflect - rail compliant
  • HiVis LS - yellow/blue
  • HiVis LS - orange/navy
  • HiVis
  • No minimum standard
  • Other

• If "Other" (detail)

• Pants?

  Forsythes

  Host Employer/ PCBU/ Not Applicable

• Minimum Standard:

  Long drill pant, reflect - navy

  Long drill pant - navy

  Long drill pant

  No minimum standard

  Other

• If "Other" (detail)

• Safety Eyewear?

  Forsythes

  Host Employer/ PCBU/ Not Applicable

• Minimum Standard:

  Tint

  Clear

  Other

• If "Other" (detail)

• Hearing Protection?

  Forsythes

  Host Employer/ PCBU/ Not Applicable

• Minimum Standard:

  Ear muffs

  Ear plugs

  Other

• If "Other" (detail)

• Gloves?

  Forsythes

  Host Employer/ PCBU/ Not Applicable

• Minimum Standard:

  Ninja

  Rigger

  Welding

  No minimum standard

  Other

• If "Other" (detail)

• Hard hat?

  Forsythes

  Host Employer/ PCBU/ Not Applicable

• Minimum Standard:

  Ear muffs

  No minimum standard

  Other

• If "Other" (detail)

• Respiratory equipment?

  Forsythes

  Host Employer/ PCBU/ Not Applicable

• Minimum Standard (detail):

• Other (list):

Pre Deployment Processes: Medical

• Pre Employment Medical?

  Yes

  No

  N/A

• "Assemble" the required pre employment medical assessment using the below specific components. If a pre employment medical assessment is not requested, however, specific examinations are, select below as required.

• Physical examination?

  Yes

  No

  N/A

• Spirometry (lung function)?

  Yes

  No

  N/A

• Audiometry (hearing)?

  Yes

  No

  N/A

• Drug & Alcohol?

  Yes

  No

  N/A

• If "Yes", Urine - instant or laboratory? Saliva?

  Instant

  Laboratory

  Saliva

  No preference

• ECG ( Heart)?

  Yes

  No

  N/A

• Pathology (blood tests)?<br>if "Yes", list reason for test(s) & test types to be completed.

  Yes

  No

  N/A

• Functional Capacity Assessment?

  Yes

  No

  N/A

• Other (list)?

Pre Deployment Processes: Background Assessment

• Criminal History?

  Yes

  No

  N/A

• Working with Children?

  Yes

  No

  N/A

• Qualifications?

  Yes

  No

  N/A

• Other (list)?

General Comments

Site Attendance & Inspection Frequency

• Minimum Expectation:

  Daily

  Weekly

  Fortnightly

  Monthly

  Forsythes to determine

Assessment Validation

• Business Representative:

  Sign

• Business Representative (if applicable):

  Sign

• Forsythes Representative:

  Sign

• Forsythes Representative (if applicable):

  Sign