Information

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Personnel

  • Personnel

Visit Category

  • What type of visit is this?

Access / Egress

  • 1 - Is it safe to park the vehicle on the road/car park?

  • 2 - Where a gate is fitted, is the gate easy to open and close?

  • 3 - Is the pathway from vehicle to the property safe? e.g. lighting, overgrown trees/grass, trip hazards etc. If No, please create an action.

  • 4 - Where pets are present are they restrained and/or non-threatening?

  • 5 - Are verandahs or decks in good repairs and are steps/handrails safe? If No, please create an action

  • 6 - Are doorways clear and free from obstruction and easy to close?

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Security

  • 1 - Are all locks at the property in good working order both external and internal?

  • 2 - Is the lock box outside the property damage free and are the keys secure?

  • 3 - Do the SW's know the codes for the lock box, or know where they can find them?

  • 4 - Are all workers aware of the lock up process when leaving the property?

  • 5 - Is there a visitors register in use?

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Fire & Emergency

  • 1 - Are evacuation diagrams clearly displayed, detailing all exit points?

  • 2 - Are fire extinguishers and fire blankets available and stored in their correct locations free from obstruction?

  • 3 - Is the fire alarm system (where installed) operational?

  • 4 - Are fire exits clearly marked and free of obstructions?

  • 5 - Are exit doors easy to open?

  • 6 - Emergency lighting (where installed) is operational and serviced every 6 months?

  • 7 - Emergency drills are conducted every 6 months?

  • 8 - Is a copy of the emergency procedures readily available?

  • 9 - Where there is an Emergency Control Organisation for the property this should be clearly displayed?

  • 10 - All workers in the building are aware of the emergency procedure for the workplace?

  • 11 - Emergency kit is fully stocked and in date?

  • 9 - Comments:

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First Aid

  • 1 - The first aid kit is clearly marked and accessible?

  • 2 - Are workers aware of the first aid kit location?

  • 3 - A list of first aider's is displayed in close vicinity to the first aid kit?

  • 4 - The first aid kit is clean and contents are in date?

  • 5 - The first aid kit is adequately stocked?

  • 6 - Emergency phone numbers are displayed?

  • 7 - Are workers aware of how to report an incident?

  • 11 - Comments:

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Electrical

  • 1 - Safety switches installed and tested?

  • 2 - Plugs, sockets and switches are in good condition (check for cracks, signs of burn damage, securely fixed to wall).

  • 3 - Electrical cords in good condition (turn off power to appliance and check for frayed and damaged leads)?

  • 4 - Are leads kept tidy and not a trip hazard?

  • 5 - Are power boards used (no double adaptors)?

  • 6 - Are portable equipment and leads tested and tagged where applicable?

  • 13 - Comments:

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Gas

  • 1 - Gas Bottles where applicable are: (all should be ticked for a pass)

Environment

  • 1 - Is the temperature suitable for the physicality of the job (20-26°C)

  • 2 - Lighting is installed and operational with adequate means of controlling glare?

  • 3 - Are ventilation/air conditioning systems installed and operational?

  • 4 - Are air conditioning units serviced regularly?

  • 5 - Check the flooring for slip, trip and or spill hazards?

  • 6 - Are all walkways kept clear of obstructions?

  • 7 - Are filing cabinets and draws closed when not in use?

  • 8 - WHS Cabinet is set up according to the work instruction?

  • 9 - Is the work area free of sharp edges or surfaces that could cause injury in the course of routine workplace activity?

  • 10 - Are items stored safely so they are secure and not at risk of falling?

  • 11 - Is the area around photocopiers and printers ventilated?

  • 12 - Is the working environment free of distracting or loud noises )internal and external?

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Ergonomics

  • 1 - Position and design of furniture allows aces and correct support?

  • 2 - Space around the bed is sufficient for providing support and takes into consideration access / egress?

  • 3 - Access to shower and or bath is adequate for providing support?

  • 4 - Is the work space both on and under the desk free from clutter?

  • 5 - Have workers been made aware of how to set up their work station?

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Manual Handling

  • 1 - Mechanical lifting aids are available and used where necessary?

  • 2 - Mechanical lifting aids are serviced and the date is displayed on the equipment? Record the date where applicable:

  • 3 - Workers are trained in manual handling who have manual handling duties?

  • 4 - Manual handling risk assessments and safe lift procedures are in place?

  • 5 - Are all heavy items stored at waist height or below?

  • 6 - Are frequently used items stored between knee and shoulder height?

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Hygeine

  • 1 - Hand soap, paper towels and toilet paper are available?

  • 2 - Property is cleaned regularly?

  • 3 - Food preparation areas are clean and hygenic?

  • 4 - Bathrooms are clean and Hygenic?

  • 5 - Is there a system in place for adequate waste disposal?

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Hazardous Substances

  • 1 - All hazardous substances are locked away in WHSO cabinet?

  • 2 - All hazardous substances have a safety data sheets which is in date (5 years from date of issue)

  • 3 - All hazardous substances are correctly labelled?

  • Information displayed on poisons hotline is present and legible?

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Medication

  • 1 - Medication is locked in the WHSO cabinet at the residential property?

  • 2 - Medication is clearly labelled?

  • 3 - Are workers aware of the correct method of disposal of sharps?

  • 4 - Where needles are used is there a sharps container for disposal (usually kept inside the first aid kit)?

  • 5 - Monthly Medication Checks have been carried out?

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Psychosocial

  • 1 - Have all workers been inducted into the workplace?

  • 2 - Do all workers have a clear understanding and expectations of their roles?

  • 3 - Do all employees know how to report workplace bullying harassment, violence or other inappropriate behaviour?

  • 4 - staff have the knowledge of how to access EAP (Employee Assistance Program) and are aware of its purpose?

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Client & Communication

  • 1 - Communication book is signed by all relevant staff an comments are appropriate?

  • 2 - Client Authority forms are signed?

  • 3 - Physical space adequate for client/s?

  • 4 - Data stored correctly?

  • 5 - Pictures of client/s achievements are on display?

  • 6 - Staff hold appropriate blue/yellow card during shifts?

  • 7 - Are client/s TIM's available in the residence?

  • 8 - Is there a signed Individual Support Plan (ISP) in place? What date is on this as last reviewed?

  • 9 - ISP - Are goals clear to all?

  • Which Risk Assessments are necessary for the client/s?

  • 10 - Are all of the Risk Assessments up to date?

  • 11 - Where there is transport protocol, is this up to date?

  • 12 - Client/s activity roster is present?

  • 13 - Is there a housing agreement (contract)?

  • 14 - Is the system in place around expenditure clear and accountable?

  • 15 - Was the SW satisfied that no referrals need to be made?

  • 16 - If Restrictive Practices are in use, are they understood?

  • 17 - Are restricted objects safety secured?

  • 18 - Are healthy food options available?

  • 19 - Client was satisfied and didn't raise any concerns?

  • 20 - Are the staff present, aware of what Positive Behaviour Support means?

  • 21 - Is the SW aware of the Case Management & Planning Policy?

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Other:

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Completed By

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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.