Q 1-5

  • 1 - Health and Safety Management

  • A - Is there a clear commitment to health, safety & welfare (poster displayed and/or written policy statement-mandatory when 5 or more employees)?

  • Evidence/ Comments

  • B - How are the commitment, responsibilities and arrangements for health & safety communicated to employees?

  • C - Is there current:

  • -Employer's Liability Insurance

  • Employers Liability Insurance:

  • Insurer's Name:

  • Policy Number:

  • Expiry Date:

  • -Public Liability Insurance

  • Public Liability Insurance:

  • Insurer's Name:

  • Policy Number:

  • Expiry Date:

  • Other insurance appropriate to the business undertaking?

  • 2 - Safe and Healthy Working Environment

  • B - Is the working environment (temperature, lighting, space, ventilation, nise) an appropriate safe and healthy one?

  • Evidence/ Comments

  • A - Are premises (structure, fabric, fixtures and fittings) safe and healthy (suitable, maintained and kept clean)?

  • Evidence/ Comments

  • C - Are welfare facilities (toilets, washing, drinking, eating, changing) provided as appropriate and maintained?

  • Evidence/ Comments

  • D - Does the employer display the necessary signs and notices around the workplace?

  • Evidence/ Comments

  • 3 - Fire and Emergencies

  • B - Are there appropriate means of fighting fire in place?

  • Evidence/ Comments

  • A - Does the company have emergency evacuation procedures and what are they?

  • Evidence/ Comments

  • C - Are effective means of escape in place including unobstructed routes and exits?

  • Evidence/ Comments

  • 4 - Accidents, Incidents and First Aid

  • A - Does the company have accident and incident procedures? and what are they in relation to:
    - First Aid provision
    - Responsible person
    - Reporting procedure

  • Evidence/ Comments

  • 5 - Work Equipment and Machinery

  • B - Is equipment adequately maintained?

  • Evidence/ Comments

  • A - Is correct machinery and equipment (mechanical and/or electrical) provided to the appropriate standards?

  • Evidence/ Comments

  • C - Are guards and control measures in place as determined through risk assessment?

  • Evidence/ Comments

Q 6-8

  • 6 - Risk Assessment and Control

  • A - Have risk assessments been carried out, control measures identified and put in to place?

  • Evidence/ Comments

  • B - Do they take into account young persons, including giving consideration to their age, inexperience, immaturity and lack of awareness of risks?

  • Evidence/ Comments

  • C - Have the significant findings and details of any groups identified as being especially at risk been recorded (mandatory where 5 or more employees)?

  • Evidence/ Comments

  • 7 - Personal Protective Equipment and Clothing

  • A - Is PPE/C provided, free of charge, to employees as determined through risk assessment?

  • Evidence/ Comments

  • B - Is training and information on the safe use of PPE/C provided to employees?

  • Evidence/ Comments

  • C - Is the proper use and storage of PPE/C enforced?

  • Evidence/ Comments

  • D - Is PPE/C maintained and replaced?

  • Evidence/ Comments

  • 8 - Information, Supervision, Instruction and Training

  • A - Is health and safety information, instruction and training given to employees at induction and on an ongoing basis?

  • Evidence/ Comments

  • B - Is the health and safety information, instruction and training recorded?

  • Evidence/ Comments

  • C - Are employees provided with adequate competent supervision? If applicable - who is responsible for supervising the learner on the programme of study?

  • Evidence/ Comments

  • Please sign to agree that this is an accurate record of the assessment conducted.

  • The Employer (or their representative)

  • Signed:

  • Print Name:

  • Job Title:

  • Date:

  • Telford College of Arts and Technology (Person completing the Health and Safety Checklist)

  • Signed:

  • Print Name:

  • Job Title:

  • Date:

Action Plan

  • Action Plan - reference to numbering system in assessment record above:

  • Ref:

  • Action Required:

  • By who:

  • Target Date:

  • Completion Date:

  • Ref:

  • Action Required:

  • By who:

  • Target Date:

  • Completion Date:

  • Ref:

  • Action Required:

  • By who:

  • Target Date:

  • Completion Date:

  • Ref:

  • Action Required:

  • By who:

  • Target Date:

  • Completion Date:

  • Ref:

  • Action Required:

  • By who:

  • Target Date:

  • Completion Date:

  • Ref:

  • Action Required:

  • By who:

  • Target Date:

  • Completion Date:

  • Ref:

  • Action Required:

  • By who:

  • Target Date:

  • Completion Date:

  • Ref:

  • Action Required:

  • By who:

  • Target Date:

  • Completion Date:

  • Action plan agreed by

  • Name:

  • Signature:

  • Date:

  • Action plan prepared by

  • Name:

  • Signature:

  • Date:

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