PWM-WHS001 Induction Record

Title Page

Conducted on
Prepared by

PART A: Inductee Details

Inductee Name
Position/Job Title
Supervisor Name
Date of Birth (DOB)
Mobile Number
Email Address
Working Group

Competencies and Qualifications

Role Experience (Years)
High-Risk Work License (HRWL) Number
List of relevant qualifications/licenses/tickets for the role/work being undertaken

Health Details

Do you have any medical conditions that may affect work duties?
What is the condition?
Do you have any medical conditions that may be affected by work duties?
What is the condition?
Do you require any medication?
What is the medication?
Have you had any work-related injuries in the last 12 months?
What is the injury and was it major?

Emergency Contact Details

Name
Phone
Relationship
In accordance with the applicable legislation, I understand that i must have completed a general construction induction (White Card) training, a site induction and relevant work’s activity induction prior to the commencement of any construction work.

Declaration

I certify that the information I’ve provided above is true and correct. I have the necessary competency to undertake the work as per my occupation & job description and I am medically fit to safely perform the respective task(s) required of me. Furthermore, I confirm the elements included in 'Introduction' and 'The following has simultaneously been confirmed' has been covered and thoroughly explained to me during the induction.

Introduction:

Introduced to other staff, managers, and company administrators, specifically personnel responsibilities operationally
Introduced to the first aid officer and shown the location of first aid supplies, with all injury/return-to-work procedures specified.
Explained all emergency procedures, work’s scope, working hours and senior personnel.
Introduced to the site’s rules, policies, and procedures, both specific and general.
Shown the work area, parking spaces, amenities, drinkable water, eating facilities, exits, entries and equipment.
Shown how to safely use, store & maintain equipment (tools, etc.) and hazardous substances (if applicable).

The following has simultaneously been confirmed:

Roles and responsibilities of people in the workplace regarding WHS.
Hazards in the workplace, how they are controlled and how to report hazards/risks.
The required PPE (According to SWMS), conformance with all relative SWMS and specific management procedures
How to report an injury and the importance of immediate reporting of serious injuries.
Consultation about WHS consultation – how they will be kept informed about health and safety issues.
The ban of drugs, smoking and alcohol on the site.
Traffic management, specifically the approved movement of all machinery and the consequences of non-compliance.
The company’s quality standards and how their installations will be monitored to ensure compliance.
The importance of compliance in accordance with the company’s policies and procedures.
The company’s misconduct system to ensure both parties understand expectations and standards.

PART B: Final Declaration

I, the personnel conducting works onsite, have read and understood this site induction. This induction record has sufficiently demonstrated how to conduct work safely on-site and if any risks are present which have not been mentioned, I will notify the appropriate personnel immediately. I understand I am required to work in accordance with Safe Work standards, local authorities, the Work Health and Safety Act 2011 and Work Health and Safety Regulation 2017 correspondingly conforming with licensing requirements for conducting specific works. This specifically includes the maintenance of all required licenses/permits, including but not limited to: (1) White Cards (2) Plant Operator Qualifications (3) First Aid / CPR. In signing this induction record, I hereby agree to adhere to the site’s policies, procedures & rules outlined during and after this induction. Any items of concern or queries have been addressed, with further questions addressed to management in the nearby future in accordance with consultation procedures. I will comply with any reasonable instruction given to me by site management or their representatives in the pursuit of a hazard free & safe working environment, specifically in accordance with the allocated SWMS(s) and company procedures.

Declarations

I declare that I understand the base requirements of my role and I will comply with any reasonable instruction given to me by company management, or their representatives, in the pursuit of a hazard free and safe working environment.
I declare that the company structure has been explained to me and that I understand the company structure and who I am accountable to.
I declare that I will endeavour at all times to uphold the name of the company by acting in a sensible and safe manner at all times and by being a responsible employee who upholds sound Industry Standards.
I have understood the items covered by the company induction, as indicated by the ticks that I have placed against each of the items, and I hereby agree to adhere to the policies, procedures, standards, and rules outlined during this induction.
I declare that I have read all signed company policies (signed by the managing director)
I declare that I have had the purpose and importance of PPE explained to me and declare that I understand my obligations fully. I have been given the opportunity to ask questions which were answered by an authorised company representative.
I declare that I will be provided with compliant PPE, required to conform with safety standards and regulations.
I declare that I will work in accordance with the company’s policies, explained to me following this induction.
I declare that I understand the misconduct management system and will comply with the company’s performance expectations. Following two (2) non-conformance/misconduct notice letters, I understand that if my non-conformance(s) haven’t been rectified, I am prone to termination. I make this declaration in good faith and understand in the event I am found to be seriously negligent of these policies, procedures, my job roles, and responsibilities; that I may be subject to disciplinary action by the company.