Site specific Induction Checklist

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Known Allergies / Medical conditions that may affect your work

Certificates of Competency / Licences

• White Card Sighted

  Yes

  No

  N/A

Issues Specific to this site

• WHS Management Plan

  Yes

  No

  N/A

• Site Safety Rules / Procedures

  Yes

  No

  N/A

• Emergency Procedures (incident/1st aid kit location / evacuation)

  Yes

  No

  N/A

• Site Specific Hazards / Risk Control Measures

  Yes

  No

  N/A

• Incident / Hazard / Injury Reporting

  Yes

  No

  N/A

• Amenities

  Yes

  No

  N/A

• High Risk Activities / Safe Work Method Statements

  Yes

  No

  N/A

• Housekeeping

  Yes

  No

  N/A

• Testing & Tagging

  Yes

  No

  N/A

• Material Safety Data Sheets

  Yes

  No

  N/A

• PPE Requirements

  Yes

  No

  N/A

• I acknowledge having been inducted into the above mentioned site and had explained to me the topics above as indicated. I agree to comply with all conditions, site rules and requirements.

Person Being Inducted:

• Signature

  Sign