• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by:

  • Location
  • Personnel

Workplace Violence Risk Factors:

  • Do employees exchange money with the public?

  • Do employees deliver passengers or goods?

  • Do employees have contact with the public?

  • Do employees work alone?

  • Do employees work late at night or during early morning hours?

  • Is the workplace often understaffed?

  • Is the workplace located in an area with a high crime rate?

  • Have neighboring facilities and businesses experienced violence or crime?

  • Do employees enter areas with a high crime rate?

  • Do employees operate from a mobile workplace (patrol vehicle, work van, etc...)?

  • Do employees perform jobs that might put them in conflict with others?

  • Do employees ever perform duties that could upset people (deny benefits, confiscate property, terminate child custody, etc...)?

  • Do employees deal with people known or suspected of having a history of violence?

  • Do any employees or supervisors have a history of assault, verbal abuse, harassment, or other threatening behavior?

  • Other risk factors - please describe:

  • Risk Factor
  • Add notes:

  • Add media

Work Areas:

  • Who is responsible for building security?

  • Are workers told or can they identify who is responsible for security?

  • Are name tags or ID badges required for for all employees (omitting personal information such as last name and home address)?

  • Are authorized visitors to the building required to wear ID badges?

  • Are visitors or clients escorted to offices for appointments?

  • Are workers notified of past violent acts in the workplace?

  • Are trained security personnel accessible to workers in a timely manner?

  • Are trained counseling personnel accessible to workers in a timely manner?

  • Do security and/or counseling personnel have sufficient authority to take all necessary action to ensure worker safety?

  • Are bullet-resistant windows or similar barriers used when money is exchanged with the public?

  • Is there an established liaison with local law enforcement, emergency services, and counseling agencies?

  • Are areas where money is exchanged visible to others who could help in an emergency?

  • Is a limited amount of cash kept on hand, with appropriate signs posted?

  • Are employees given maps and clear directions in order to navigate the areas where they will be working?

  • Are floor plans posted showing building entrances, exits, and location of security personnel?

  • Are these floor plans visible only to staff and not outsiders?

  • Is additional emergency information posted, such as telephone numbers?

  • Are there enough exits and adequate routes of escape?

  • Can exit doors be opened only from the inside to prevent unauthorized entry?

  • Is the lighting adequate to see clearly in indoor areas?

  • Are there employee-only work areas that are separate from public areas?

  • Is access to work areas only through a reception area?

  • Are reception and work areas designed to prevent unauthorized entry?

  • Is public access to the building controlled?

  • Could someone hear a worker who calls for help?

  • Can employees observe patients or clients in waiting areas?

  • Do areas used for patient or client interviews allow co-workers to observe any problems?

  • Are waiting areas and work areas free of objects that could be used as weapons?

  • Are chairs and furniture secured to prevent their use as weapons?

  • Is furniture in waiting areas and work areas arranged to prevent entrapment of workers?

  • Are patient or client waiting areas designed to maximize comfort and minimize stress?

  • Are patients or clients in waiting areas clearly informed how to use the department's services to minimize frustration?

  • Are waiting times for patient or client services kept short to minimize frustration?

  • Are private, locked restrooms available for employees?

  • Is there a secure place for workers to store personal belongings?

  • Are special security measures taken to protect people who work late at night (escorts, locked entrances, etc...)?

  • If weapons are on-site are they secured and stored in a location that is physically separated from patient or client access areas?

Exterior Building Areas:

  • Do workers feel safe walking to and from the workplace?

  • Are the entrances to the building clearly visible from the street?

  • Is the area surrounding the building free of bushes or other hiding places?

  • Is lighting bright and effective in outside areas?

  • Are security personnel provided outside the building?

  • Is video surveillance provided outside the building?

  • Are remote areas secured during off shifts?

  • Is a buddy escort system required during off shifts?

  • Are all exterior walkways visible to security personnel or managers?

Parking Areas:

  • Is there a nearby parking lot reserved for employees only?

  • Is the parking lot attended or otherwise secured?

  • Is the parking lot free of blind spots and is landscaping trimmed back to prevent hiding places?

  • Is there enough lighting to see clearly in the parking lot and when walking to/from the building?

  • Are security escorts available to employees walking to and from the parking lot?

Security Measures:

  • Physical barriers (plexiglass partitions, bullet-resistant customer window, etc...)?

  • Proximity card access?

  • Security cameras or closed-circuit TV in high-risk areas?

  • Panic buttons?

  • Alarm systems?

  • Metal detectors?

  • Security Screening devices?

  • Door locks?

  • Perimeter door panic locks?

  • Internal telephone system to contact emergency assistance?

  • Telephone system with an outside line programmed for 911?

  • Telephone system emergency intercom system in place?

  • Two-way radios, pagers, or cellular telephones?

  • Security mirrors (e.g., convex mirrors)?

  • Secured entry (e.g., "buzzers")?

  • Personal alarm devices?

  • "Drop safes" to limit the amount of cash on hand?

  • Fire alarm pulls?

  • Broken windows repaired promptly?

  • Security systems, locks, panic buttons, etc. tested on a regular basis and repaired promptly when necessary?


  • Is a site specific Workplace Security/Violence Plan in place?

  • Are there standard operating procedures in place to handle specific anticipated scenarios?

  • Are workers trained in the emergency response plan (for example, escape routes, and notifying the proper authorities)?

  • Are workers trained to report violent incidents or threats?

  • Are workers trained in how to handle difficult clients or patients?

  • Are workers trained in ways to prevent or defuse potentially violent situations?

  • Are workers trained in personal safety?

  • Are workers trained in self defense?

Field Work:

    Are field activities away from the office conducted?

Field Work - Staffing:

  • Is assistance provided to workers in the field in a timely manner when requested?

  • Are escorts or "buddies" provided for people who work in potentially dangerous situations?

Field Work - Training:

  • Are workers briefed about the area in which they will be working (gang colors, neighborhood culture, language, drug activity, etc...)?

  • Can workers effectively communicate with people they meet in the field (same language, etc...)

  • Are people who work in the field late at night or early mornings advised about special precautions to take?

Field Work - Work Environment:

  • Is there enough lighting to see clearly in all areas where workers must go?

  • Are there safe places for workers to eat, use the restroom, store valuables, etc...?

  • Are there safe places where workers can go for protection in an emergency?

  • Is safe parking readily available for employees in the field?

Field Work - Security Measures:

  • Are workers provided two-way radios, pagers, or cellular phones?

  • Are workers provided with personal alarm devices or portable panic buttons?

  • Are vehicle door and window locks controlled by the driver?

  • Are vehicles equipped with physical barriers (plexiglass partitions, etc...)?

  • Are workers using Fleet vehicles?

  • Are Fleet vehicles equipped with GPS?

Field Work - Work Procedures:

  • Are employees given maps and clear directions for covering the areas they will be working?

  • Are employees given alternative routes to use in neighborhoods with a high crime rate?

  • Does a policy exist to allow employees to refuse service to clients or customers (in the home, etc...) in a hazardous situation?

  • Has a liaison with law enforcement been established?

  • Do workers avoid carrying unnecessary items that someone could use as a weapon against them?

  • Does the employer provide a safe vehicle or other transportation for use in the field?e

  • Does the employer require workers to utilize Fleet vehicles for field use?

  • Are vehicles used in the field routinely inspected and kept in good working condition?

  • Is there always someone who knows where each field worker is?

  • Is there a check in time system in use for field workers?

  • Are name tags required for workers in the field (omitting personal information such as last name)?

  • Are field workers notified of past violent acts by particular clients, patients, etc...?

Field Work - Are Special precautions taken when workers:

  • Have to take something away from people (remove children from home)?

  • Have contact with people who behave violently?

  • Have contact with people with known medical issues?

  • Use vehicles or wear clothing marked with the name of an organization that the public may strongly dislike?

  • Perform duties inside people's homes?

  • Have contact with dangerous animals

Activity Certification:

  • Facility/Site Representitive(s):

  • Representitive:
  • Title:

  • Add signature

  • Analyst(s):

  • Analyst:
  • Title:

  • Add signature

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