Title Page
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Site
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Date
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Name
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Location / department
Report detail
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Action categories
- Service Team
- Management
- Administration
- Customer
- Health & Safety
- Other
Service Team action
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Please select service type
- Stock report
- Equipment check / report
- pre start check
- general / task report
- customer request
- Customer Satisfaction
- time sheet
- CW3
- Cleaning Inspection
- Service Team Complaint
Stock Items
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Stock location
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Date / Time
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Please confirm current stock levels
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Please confirm stock requirements (leave blank if no additional stock required)
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Please confirm the stock room has a copy of the cleaning playbook
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Confirm the cleaners stock room (including all equipment) is clean and tidy and in good condition.
Confirmation
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Signature
Please ensure your stock room is clean and tidy - if it is not you must contact your line manager immediately
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Please confirm you have taken the necessary action by print / date / and signing this report.
Service inspection / task report
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Inspection carried out by
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Date / time
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Details of Inspection / Task
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Any further actions required
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List further actions
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Sign to confirm completion of task / service as to the required specification.
Equipment inspection / check
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Name
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Equipment location
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Date / Time
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Equipment type
- manual equipment
- Powered equipment
Manual equipment inspection checklist
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List item(s) inspected
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List all items that are in a poor condition and/or are unsafe to use (leave blank if not applicable)
You must not use any item in poor condition and / or unsafe to use - please sign below to confirm you have removed the item from use and have contacted your line manager
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Signature
Powered equipment inspection
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List item of powered equipment inspected (including serial number)
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Does the item (including battery charging units) have a valid PAT Test label (select n/a for battery powered equipment )
You must take immediate action
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Do not use the piece of equipment - lock the unit away and display a warning notice - contact your line manager.
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Sign to confirm you have removed the item from service and contact your line manager.
Visual inspection
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Have you identified any faults from a visual inspection of the equipment (including cracks/chips/punctures/holes in the external housing of the unit and/or any exposed/damaged wiring)
You must take immediate action
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Do not use the piece of equipment - lock the unit away and display a warning notice - contact your line manager.
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Sign to confirm you have removed the item from service and contact your line manager.
General condition
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Does the unit appear in good condition and operate correctly.
You must take immediate action
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Do not use the piece of equipment - lock the unit away and display a warning notice - contact your line manager.
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Sign to confirm you have removed the item from service and contact your line manager.
The equipment is safe to use - make sure it is left clean and in a usable condition - is neatly & securely stored after use.
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Signature
Visual inspection
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Have you identified any faults from a visual inspection of the equipment (including cracks/chips/punctures/holes in the external housing of the unit and/or any exposed/damaged wiring)
You must take immediate action
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Do not use the piece of equipment - lock the unit away and display a warning notice - contact your line manager.
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Print / date / sign to confirm you have removed the item from service and contact your line manager.
General condition
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Does the unit appear in good condition and operate correctly.
You must take immediate action
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Do not use the piece of equipment - lock the unit away and display a warning notice - contact your line manager.
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Print / date / sign to confirm you have removed the item from service and contact your line manager.
The equipment is safe to use - make sure it is left clean and in a usable condition - is neatly & securely stored after use.
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Print / date / sign
Pre start check - Risk Assessment/Method Statement
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Name
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Date / time
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Have you read a valid risk assessment & method statement for the task you are about to carry out
You must not start work - contact your line manager
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Signature
Control measures
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Have you deployed all control measures and carried out the necessary actions as detailed in the risk assessments and method statements (above)
You must not start work - contact your line manager
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Sign
Additional controls
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Have you identified any additional risks (not identified in the risk assessment)
Your well-being
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Have you received the necessary training you require and do you feel you are able to complete the task.
You must not start work
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Print / date / sign
You may start work
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Print / date / sign
Additional Risks & Controls
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List the risks you have identified in addition to those already identified in the risk assessment
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List the additional measures you have implemented to control the additional risks (detailed above)
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Are you sure you now have all suitable and sufficient controls in place for you to carry out the work safely?
You must not start work - contact your line manager
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Signature
Your well-being
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Have you received the necessary training you require and do you feel you are able to complete the task.
You must not start work
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Signature
You may start work
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Signature
Time sheet
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Week commencing
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Full Name
Monday
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Start time
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Finnish time
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Total time worked (excluding break times)
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Shift report
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Any further actions required (include detail)
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Signature (required)
Tuesday
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Start time
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Finnish time
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Total time worked (excluding break times)
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Shift report
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Any further actions required (include detail)
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Signature (required)
Wednesday
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Start time
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Finnish time
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Total time worked (excluding break times)
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Shift report
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Any further actions required (include detail)
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Signature (required)
Thursday
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Start time
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Finnish time
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Total time worked (excluding break times)
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Shift report
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Any further actions required (include detail)
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Signature (required)
Friday
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Start time
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Finnish time
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Total time worked (excluding break times)
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Shift report
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Any further actions required (include detail)
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Signature (required)
Saturday
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Start time
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Finnish time
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Total time worked (excluding break times)
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Shift report
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Any further actions required (include detail)
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Signature (required)
Sunday
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Start time
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Finnish time
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Total time worked (excluding break times)
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Shift report
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Any further actions required (include detail)
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Signature (required)
Weekly timesheet summary
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Total weekly hours worked
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Additional comments
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Print / date / sign to confirm you have checked the detail you have provided and it is accurate and correct to the best of your knowledge
CW3 - continuous improvement
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Task / service involved
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Existing equipment /methods / controls used to complete task
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Labour resource required to complete task
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Budget costs to complete task (if known)
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CW3 suggestion
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Proposed Equipment /methods / controls to complete the task
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Labour resource required to complete the task
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budget costs to complete the task (if known)
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Outline the benefits of this CW3 Initiative
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Please print / sign
Cleaning Inspection
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Location details
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Type of location
- Office
- Stairs &corridoors
- Lifts
- Reception
- Washroom
- Rest room / vend area / canteen / restaurant
- Outside
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Are here any bins / waste stations in the area
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Other
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Are here any bins / waste stations in the area
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Other
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Are here any bins / waste stations in the area
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Is there a stairwell
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Other
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Other
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Does the location have urinals ?
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Does the location have showers ?
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Other
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Other
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Other
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Date print sign
Service Team Complaint
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Nature of complaint
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Required Action
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Additional comments
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Print/date/sign
Manager / inspection / report
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Management role
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Type of report
Cleaning Audit
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Location details
Stairwells
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Stairwell location
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Are there any bins / waste stations in the area
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Other
Corridors
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Are there any bins / waste stations in the area
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Other
Reception
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Are here any bins / waste stations in the area
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Other
Lifts
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Are there any waste receptacles
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Other
Office
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Are here any bins / waste stations in the area
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Other
Washroom locations
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Please add location details
General appearance & comments
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Comments
Toilets
Structure
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Washroom location to be free from prevailing malodour/ unpleasant smells
Consumables
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Washroom location consumables are all dispensers stocked with a plentiful supply to last between visits
Hand wash sinks/basins/troughs
Showers
Urinals
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Other
External Areas
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Other
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Date / Print / Sign
Storeroom Inspection
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Please confirm location
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Please confirm current stock levels
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Please confirm stock requirements (leave blank if no additional stock required)
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Please confirm the stock room has a copy of the cleaning playbook
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Confirm the cleaners stock room (including all equipment) is clean and tidy and in good condition.
Confirmation
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Date and sign
Please confirm further Actions required
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undefined
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Please confirm you have taken the necessary action by print / date / and signing this report.
PPE type
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Name of team / operative
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Please indicate the uniform / PPE being worn at the time of assessment
- Safety shoes
- Work trousers
- Polo shirt
- Dress shirt / blouse
- Jumper
- Sweatshirt
- Fleece
- Jacket
- Coat
- High vis
- Safety helmet
- Bump cap
- Safety specs
- Goggles
- Face visor
- Gloves
- Ear protection
- Face mask
- Other
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‘Other’ Uniform/PPE type
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Are all items of ppe (as detailed in the risk assessments/ method statements) being worn by the affected personnel
Additional comments
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undefined
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Print / date / sign
Do not allow work to continue - It is both a legal & mandatory requirement to wear company safety clothing and personal protective equipment (PPE) - failure to do so may lead to disciplinary proceedings.
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Please detail any uniform / PPE to be replaced and necessary action required (leave blank if not required)
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Please confirm any further measures taken / required
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Print/ date/ sign
Competency Assessment
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Name of Operative
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Details of Operatives training (relevant to the task)
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Details of task(s) undertaken
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Does the Operative understand the work instructions within RAMS & Associated documentation
It is a requirement of health and safety law to understand all aspects of the RAMS & associated documents for the task being undertaken - the operative must not continue until familiar with the requirements of all associated documentation. Please detail further action taken / required (below)
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Print / date / sign
Workplace set up
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Are all necessary safety controls in place
Work must not commence until all safety control measures are in place- Please detail further action taken / required (below) including any further training requirements.
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Print / date / sign
Uniform & PPE
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Are all necessary items of work ware & PPE in good condition and in use when completing the task
Work must not commence until all uniform & PPE has been checked is worn and is in good condition. Please detail further action taken / required (below) including any further training requirements.
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Print / date / sign
Methodology
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Is the work being carried out in line with the requirements of the applicable documentation
Work must not be carried out without using the correct methods and equipment to complete the task - Please detail further action taken / required (below) including any further training requirements.
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Print / date / sign
Capabillity
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Does the operative confirm their ability to complete the task
Work must not commence if the operative is not sure if he can complete the task as per the required specification. Please detail further action taken / required (below) including any further training requirements.
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Print / date / sign
Assessment
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Do you believe the operative is capable & competent to complete the task
Work must not commence unless you are sure the operative has received the necessary training and instruction and is capable & competent to complete the task - Please detail further action taken / required (below) including any further training requirements.
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Print / date / sign
Successful completion of this assessment
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Print/ date/ sign
General administration ‘ forms
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Please select form below
- Sick form
- holiday form
- time sheet
- Customer request
- customer complaint
- customer satisfaction
- customer feedback
Sickness / Absence notification form - please complete as soon as you become aware you are unable to attend.
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Name
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Department
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Line manager
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Please confirm the date you are unable to attend work
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Please state the reason you are unable to attend work
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Signature
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Thank you for completing the notification - please note we will contact you shortly for further information regarding your absence to better understand what support we can offer you and what you feel would be the anticipated term of absence.
Holiday form
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Name
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Department
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Line manager
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Requested dates
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Number of days requested
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Signature
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Your request has been submitted for approval - please note you must receive approval to confirm your holiday request has been granted
Time sheet
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Week commencing
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Name
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Department
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Line manager
Monday
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Start time
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Finnish time
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Total time worked (excluding break times)
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Shift report
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Any further actions required (include detail)
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Signature (required)
Tuesday
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Start time
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Finnish time
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Total time worked (excluding break times)
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Shift report
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Any further actions required (include detail)
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Signature (required)
Wednesday
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Start time
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Finnish time
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Total time worked (excluding break times)
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Shift report
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Any further actions required (include detail)
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Signature (required)
Thursday
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Start time
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Finnish time
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Total time worked (excluding break times)
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Shift report
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Any further actions required (include detail)
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Signature (required)
Friday
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Start time
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Finnish time
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Total time worked (excluding break times)
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Shift report
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Any further actions required (include detail)
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Signature (required)
Saturday
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Start time
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Finnish time
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Total time worked (excluding break times)
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Shift report
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Any further actions required (include detail)
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Signature (required)
Sunday
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Start time
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Finnish time
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Total time worked (excluding break times)
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Shift report
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Any further actions required (include detail)
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Additional comments
Timesheet Summary
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Total weekly hours worked
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Signature (required)
Health and Safety
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Report type
Pre start check - Risk Assessment/Method Statement
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Name
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Position
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Task (include job ref where applicable)
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Date
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Have you read a valid risk assessment & method statement for the task you are about to carry out
You must not start work - contact your line manager
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Signature
Control measures
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Have you deployed all control measures and carried out the necessary actions as detailed in the risk assessments and method statements (above)
You must not start work - contact your line manager
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Signature
Additional controls
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Have you identified any additional risks (not identified in the risk assessment)
Your well-being
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Have you received the necessary training you require and do you feel you are able to complete the task.
You must not start work
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Signature
You may start work
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Signature
Additional Risks & Controls
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List the risks you have identified in addition to those already identified in the risk assessment
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List the additional measures you have implemented to control the additional risks (detailed above)
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Are you sure you now have all suitable and sufficient controls in place for you to carry out the work safely?
You must not start work - contact your line manager
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Print / date / sign
Your well-being
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Have you received the necessary training you require and do you feel you are able to complete the task.
You must not start work
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Print / date / sign
You may start work
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Print / date / sign
Safety Observation
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Name
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Position
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Select date
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Please provide details about your safety observation
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Please highlight the safety considerations in relation to the above observation
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In your view is it safe for the activity you have observed to continue
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You should request the personnel involved stop work as it is not safe to continue and report this to your line manager immediately
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Please highlight good practice / how safety can be improved in relation to the above
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Please print / sign
2 Minute Risk Assessment
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Name
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Date / Time
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Description of task
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Hazard noted before starting task
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Person(s) at risk
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Control measures in place before starting task
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Is it safe to start with the above control measures in place
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What additional control measures do you recommend
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Have you implemented the additional control measures (detailed above)
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Do not start work - contact your line manager
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Date/ Print/ Sign
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You may start work - Remember to continually assess the area in case additional hazards occur. (Complete a new 5 minute risk assessment if new hazards &/or risks are identified)
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Date/ Print/ Sign
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You may start work - Remember to continually assess the area in case additional hazards occur. (Complete a new 5 minute risk assessment if new hazards &/or risks are identified)
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Date/ print/sign
Customer Report
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Please select which type of report you wish to make
Customer Satisfaction Report
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Name of person wishing to comment
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Date / time
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Which service do you wish to comment on
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Would you like to comment on how the service can be improved
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Please print/ sign
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Thank you for your feedback - your comments are greatly appreciated and will help us to improve our service delivery on site
Customer Request
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Priority
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Pass request to help desk immediately on completion
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Task details
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Requested Completion date
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Further action required
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Print / sign
Customer Complaint
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Nature of complaint (please provide details)
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Please provide contact details
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Please Print / date / sign
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Thank you for your feedback - we will contact you shortly to address your issues.
Customer Service Team Appraisal
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Please select a category
- Site Management
- Security
- Front of house
- Cleaning
- Catering
- Grounds Maintenance
- Hard Services
- Individual / Team Member
- Overall EMCOR performance
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Please identify who your comments are in relation to
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Using the following sliders please indicate your level of satisfaction between 1&10 (1=poor / 10=excellent)
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Any further comments
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Print/ date/ sign
Customer Comments
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Please provide comments
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Please provide detail of any further action required
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Please provide contact details
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Please print / date / sign
General Report
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Name
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Date / time
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Please detail your comments
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Please detail further required actions
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Please detail when action is required by
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Print/ date/ sign