Spotless Services - Take 5

• Work Order number

• Take 5 Safety@Spotless

• Conducted on

  Date

• Name

• Address
  Address

1.STOP

• Is this a ROUTINE Task?

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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• Have I read and understood the Safe Work Procedure (SWP) for this task?

  Yes

  No

• HAZARDS

• CONTROLS

• RISK SCORE

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• Does this task require JSA/Permit?

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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• Have I inspected the work area?

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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• HAZARD

• CONTROLS

• RISK SCORE

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• Are the tools/equipment 'Fit For Purpose'?

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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• Am I trained and competent to complete the Task?

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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• Do I have the right PPE for this task?

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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2. THINK ABOUT AND LOOK FOR HAZARDS

• Have I completed the pre-start check list for any pieces of the equipment?

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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• Do I have the correct equipment when/if working with sharps?<br>(eg. Knives, carton cutters, broken crockery)

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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• Do I require an observer for the task?

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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• Is there a way I could get my hand or any pieces of clothing trapped or caught in equipment or environment?

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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• Do I need to use a chemical substances or likely to be exposed to one?

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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• I know how to use chemical safely and how to manage a spill?

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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• Will the task involve interaction with other workers or workgroups?

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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• Does the task require me to do any hazardous manual tasking?<br>(eg repetitive movement, lifting or manoeuvring loads, awkward or static postures)

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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• HAZARD

• CONTROLS

• RISK SCORE

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• HAZARD

• CONTROLS

• RISK SCORE

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• HAZARD

• CONTROLS

• RISK SCORE

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• Will this task take longer than 1 hour, without any changes?<br>(if so, you will need to consider task organization)

  Yes

  No

• HAZARD

• CONTROLS

• RISK SCORE

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RESPOND

• Have I established all necessary controls?

  Yes

  No

• Name/s of worker involved in the task

• Signature

  Sign

• STOP WORK AND INFORM YOUR SUPERVISOR OR MANAGER. REMEMBER - IF ITS NOT SAFE DON`T DO IT

• Name/s of worker involved in the task

• Upload any relevant photos

  Media

• Signature

  Sign