Information

  • Client

  • Location
  • Conducted on

  • Duration of work activity

  • Activity covered by this assessment

  • Circumstances which will require additional assessment

1. Working at Heights

  • 1.1. Fall risks of 2m or more? (including voids, pits, and trenches)

2. Tools and Equipment

  • 2.1. Unsafe or damaged tools/equipment? (including missing or damaged guards, electrical test leads etc)

  • 2.2. Incorrect tools /equipment for job? (e.g. Non insulated screwdrivers etc)

  • 2.3 Power tools appliance tested.

  • 2.4. Test meters calibrated?

3. Loft spaces

  • 3.1. Safe and secure access to the loft (i.e loft ladder or extendable ladder safety positioned)

  • 3.2. Loft has adequate flooring to work in or a crawl board in place where work is to take place

  • 3.3 Adequate lighting in place to avoid addition risk of injury

4. Other people and animals (pets) at the property

  • 4.1. Customer and other adult occupants aware of the work area and agree to avoid entering it until work area is cleared away?

  • 4.2. Children and other vulnerable people under due care from a competent adult and restricted from entering the work zone

  • 4.3. Support systems in place for unsupervised vulnerable people. (i.e. heating kept on for elderly person, emergency call phone line still attached)

  • 4.4. Approved warning and health and safety signs on display in a prominent area?

5. Noise

  • 5.1. All occupants of the property protected from noise above 83dB(A)

6. Ladders

  • 6.1. Unsafe or damaged ladders?

  • 6.2. Unsafe positioning of ladders?

  • 6.3. Ladder not properly secured?

  • 6.4. Ladder unsuitable for job? (e.g. Step ladder used for accessing loft spaces)

7. Work area and manual Tasks

  • 7.1. Risk of exposure to live electrical contact

  • 7.2. Risk of damage or injury from heavy lifting?

  • 7.3. Work area clean and tidy?

8. Asbestos exposure

  • 8.1. Asbestos present?

9. Personal Protective Equipment (PPE)

  • 9.1. Lack of, or inadequate PPE (including sun protection)

  • 9.2. Lack of system to issue, inspect, replace and monitor PPE?

  • 9.3. Lack of training in safe use, clean-up and inspection of PPE?

10. Goods/valuables affected by work

  • 10.1. Customer property in good condition, robust enough to be moved?

  • 10.2. Perishable goods protected(i.e. freezer supply maintained during works)

  • 10.3. Customer carpets and other belongings protected from exposure to excessive dust?

11. Electrical and chemical Hazards

  • 11.1. Overloading outlets?

  • 11.2.. Leads placed on ground or on metal structures?

  • 11.3. Electrical equipment near chemicals that could cause damage?

  • 11.4. Electrical leads that may be damaged from contact with moving machinery parts?

  • 11.5. Electrical leads on work surfaces?

  • 11.6. No exposed live parts of electrical installation present during works?

  • 11.7 Adequate RCD Protection installed.

  • 11.8 Chemical hazards affecting workers?

12. Additional specific hazards identified.

  • 12.1. Electric Shock

  • 12.2. Slips and trips

  • 12.3. Other contractors working nearby

  • 12.4. Mechanical Machinery

  • 12.5. Storage of materials

Planning and Preparation

  • Action already taken to reduce risks

  • Planning

  • Physical

  • Absolute

Managerial / Supervisory

  • Specific instruction

Training

  • Specific instruction

Corrective Actions

  • Corrective actions

Sign Off

  • Auditor's signature

  • Property owner or main resident signature to agree they will take responsibility for themselves and their other residents, guests and pets and will avoid entering the working area at all times.

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.