Title Page

  • Document No.

  • PRE VISIT RISK ASSESSMENTAudit Title

  • Given Name and Surname of Client

  • Address of Place to be Visited
  • Assessment Conducted on

  • Name of Person/s Who Prepared this ssessment

  • Personnel who are going to Site

EMPLOYEE DETAILS

  • Given Name and Surname

  • Reason for Home Visit

STAFF COMMUNICATION

  • Mobile Phone Number

  • Date and Time of Visit

  • Is there mobile phone coverage at the residence

CLIENT DETAILS

  • Given Name and Surname

  • Address
  • Phone Number

  • Mobile Phone Number

INFORMATION OBTAINED FROM REFERRING AGENCY / CLIENT

  • Which Best Describes the Residence

  • House

  • Flat / Unit

  • Single Storey

  • Multi Storey

  • Shanty

  • Which door is used for entry

  • Is there available parking on the street

  • Is the street name and number clearly visible

  • How Many People Live in the Residence

  • Who will be Present at the Visit (Excluding Bidgerdii Staff)

  • Do any occupants have a history of violence / aggressive behaviour

  • Is there a possible infection risk

  • Is anyone unwell at the moment

  • Are there any animals

  • Are they likely to bite / attack

  • If YES! are they happy to restrain the animal/s prior to, during and until after leaving

  • Is the residence in an isolated area

GENERAL COMMENTS

  • What Controls are being put in Place to Manage the Identified Risks?

  • Signed by Person who Completed this Assessment

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