RTWL Skill Loss Questionnaire

Return to Work knowledge check questionnaire

• Engineer name:

• Team:

• Prepared by:

• Location
  Address

• Conducted on

  Date

Health & Safety Knowledge Check

Vehicle

• When is it safe to make a phone call whilst driving?

  Yes

  No

  N/A

• What is the max speed limit of your van on a single carriageway that has a national speed limit?

  Yes

  No

  N/A

• What does telematics record on your van?

  Yes

  No

  N/A

• Who is responsible to ensure your van is safe for the road?

  Yes

  No

  N/A

• Name 3 of the daily checks that you carry out on your van?

  Yes

  No

  N/A

• Who is responsible to ensure your van is serviced and maintained to the manufactures guidelines?

  Yes

  No

  N/A

• When is the next service due on your van?

  Yes

  No

  N/A

• What is the speed limit for your van on a dual carriageway with a national speed limit?

  Yes

  No

  N/A

• What is the correct tyre pressure for your van and where would you find it?

  Yes

  No

  N/A

• You notice a dent on the body work of your van, what should you do first?

  Yes

  No

  N/A

Risk Assessment

• When should a risk assessment be carried out ?

  Yes

  No

  N/A

• What are the three steps you should take to deal with a hazard?

  Yes

  No

  N/A

• Name three types of hazards you may come across?

  Yes

  No

  N/A

• Give an example of how you could control a traffic hazard?

  Yes

  No

  N/A

• Give an example of a removable garden hazard?

  Yes

  No

  N/A

• If you encounter a near miss what should you do?

  Yes

  No

  N/A

• If a part of your ladder equipment can't be used for any reason, what should you do?

  Yes

  No

  N/A

• What should you do if your MFT fails during your working day?

  Yes

  No

  N/A

• What PPE do you have to control drilling hazards?

  Yes

  No

  N/A

• What is a near miss?

  Yes

  No

  N/A

Ladder Working

• When connecting a cable to a dish does your ladder need to be eye bolted ?

  Yes

  No

  N/A

• Where should your cowstail be placed on the ladder when working at height?

  Yes

  No

  N/A

• When on soft ground, what additional item should be used with your ladder?

  Yes

  No

  N/A

• Can your gravel bag be used as a replacement for your ladder mate?

  Yes

  No

  N/A

• How many points of contact should your ladder mate have with the ladder?

  Yes

  No

  N/A

• What should you do if you can't secure the ladder with an eyebolt?

  Yes

  No

  N/A

• Name 3 elements that form Sky's safe system of work triangle?

  Yes

  No

  N/A

• In addition to PPE, List 3 items of equipment that must be used when working on a ladder?

  Yes

  No

  N/A

• You are going to place your ladder against a wall, which rungs of the ladder should the microlite be fitted to?

  Yes

  No

  N/A

• At what angle should the ladder be before climbing?

  Yes

  No

  N/A

Roof Working

• What rungs of the ladder should the microlite be fitted to, when accessing a flat roof?

  Yes

  No

  N/A

• How many eye bolts are required when accessing a pitched roof?

  Yes

  No

  N/A

• At what angle does a flat roof become a pitched roof?

  Yes

  No

  N/A

• What additional equipment is required to access a dormer roof?

  Yes

  No

  N/A

• You are about to work on a flat roof that is only 1.5m wide, what piece of equipment is required to get to the area where work will be carried out?

  Yes

  No

  N/A

• What is the minimum distance between your working point and any edge, when working on a pitched roof?

  Yes

  No

  N/A

• How would you secure your CAT ladder after it has been installed safely on a roof?

  Yes

  No

  N/A

• When should we consider installing a dish onto a chimney?

  Yes

  No

  N/A

• When working on a flat roof, how close can you be to an un-protected edge before fall arrest equipment is required?

  Yes

  No

  N/A

• You are about to access a roof, you have completed a Risk Assessment. Before starting ANY work what should you do?

  Yes

  No

  N/A

Manual Handling

• What is Manual Handling?

  Yes

  No

  N/A

• What should be carried out prior to moving any load?

  Yes

  No

  N/A

• List three common injuries caused by manual handling?

  Yes

  No

  N/A

• Which way should you face prior to lifting and moving a load?

  Yes

  No

  N/A

• Whilst at work, other than at a customers property, where else would you demonstrate manual handling techniques?

  Yes

  No

  N/A

• Within your role list 5 specific hazards associated with manual handling?

  Yes

  No

  N/A

• When lowering the roof rack what PPE should be used?

  Yes

  No

  N/A

• What weighs more? Triple 14 rung ladders or 2 boxes of zone 1 dishes?

  Yes

  No

  N/A

• How many hands should be used when carrying ladders?

  Yes

  No

  N/A

• What PPE should be used at all times when carrying ladders?

  Yes

  No

  N/A

Summary:

• Engineer Practical observation:<br><br>

  Safe

  At Risk

  Unsafe

• Overall outcome & recommendations:

  Safe

  At Risk

  Unsafe

• Engineer:

  Sign

• RTW Lead Signature:

  Sign