Title Page

  • Client / Site

  • Conducted on (Date and Time)

  • Prepared by

  • Location

General Information

  • Nature of work

  • Number of participants

  • List down the names of participants

Safety Induction

  • Site layout <br>• Site operating hours, site location, and floor plan.

  • Requirements of the job <br>• Working schedules, conditions, processes and procedures.

  • General Rights and Responsibilities <br>• Explain worker rights and responsibilities as granted by legislation.

  • Government Safety Regulation <br>• Provide education about safety regulations. Identify the location of the Material Safety Data Sheets (MSDSs). Review the MSDSs for all hazardous materials to be used by the employee. Explain hazardous material labeling requirements. Conduct job-specific training.

  • Company Safety Rules and Policies <br>• Explain safety rules and policies that are specific to your company.

  • Site Rules <br>• All site personnel must sign in and out of site. Usage of mobile devices. Ensure mechanical and electrical equipment is stored properly. Keep all areas of the site tidy and free from discarded materials.

  • Site Hazards<br>• Tour the work areas and facility and discuss associated work area hazards and safe work practices.

  • Health and Safety <br>• Health and safety policies were discussed. Prohibit use of drugs and alcohol within the site.

  • Site Housekeeping <br>• Always ensures that your work area is tidy and free from any rubbish. A waste compound is provided on site for the orderly disposal of waste materials.

  • Toxic Products <br>• Identify workspaces where hazardous materials are used, stored or disposed of.

  • Food and Beverages <br>• Explain that food and beverages are only permitted to be stored in refrigerators clearly labeled "FOOD ONLY". All food and drink is to be consumed within the prescribed welfare facilities compound.

  • Welfare Facilities <br>• Location of welfare facilities (toilets, washing areas, and canteen)

  • Personal Protective Equipment (PPE)<br>• Review the PPE program if the employee will be required to wear protective equipment. Issue appropriate personal protective equipment (PPE) that must be worn as required by the work being performed.

  • In Case of Injury or Illness <br>• Review the reporting procedures in the event of an injury and/or accident.

  • Emergency Notification Form <br>• Have employee complete the Emergency Notification form. Keep a copy for your files and send a copy to your Emergency Coordinator.

  • Emergency Procedures <br>• Show and explain how to use emergency eyewashes and showers, first aid kits, fire blankets, fire extinguishers, fire exits and fire alarm pull boxes, as applicable. Demonstrate the evacuation procedures.

  • Emergency Evacuation <br>• Review the company's Emergency Evacuation Plan and explain the evacuation signals and procedures, point out proper exit routes and the designated assembly area for your Branch.

  • Emergency Contact<br>• Provide a list of names, addresses, phone numbers and fax numbers of the persons who must be contacted in case of emergency.


  • Observations and Recommendations

  • Supervisor (Full Name and Signature)

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.