Temporary Worker Safety Checklist

• Conducted on

  Date

• Prepared by

• Location
  Address

• Reviewed Workers Compensation EMR (experience modifications rate), DART (days away from work, restrictions, or job transfer)

  Yes

  No

  N/A

• Reviewed OSHA Inspection Reports Violation (OSHA.gov)

  Yes

  No

  N/A

• Reviewed DOT SAFER FMCSA Database

  Yes

  No

  N/A

• Reviewed OSHA Log and Recent Incidents

  Yes

  No

  N/A

• Reviewed Client's Injury & Illness Prevention Program (Safety Manual)

  Yes

  No

  N/A

• Review list of Job employees will be ask to do

  Yes

  No

  N/A

• Hazards workers will be exposed to

  Yes

  No

  N/A

• Protective measures in place to protect workers

  Yes

  No

  N/A

• Skills Required, certifications, etc

  Yes

  No

  N/A

• Employee training onsite (Includes staffing employees)

  Yes

  No

  N/A

Onsite Assessment

• Housekeeping (Is facility clean and are work areas free of obvious slips trip and fall hazards)

  Yes

  No

  N/A

• Exit Routes (Are they accessible, clearly marked and free and clear of obstructions/hazards)

  Yes

  No

  N/A

• Machinery (Tools and machinery in safe working condition, Machine guarding present and fixed)

  Yes

  No

  N/A

• PPE (PPE Required in facility, consistent proper usage, training, employer provides)

  Yes

  No

  N/A

• Ergonomics (Working from nuetrual work positions encouraged, Lifting/handling aides, design of work stations)

  Yes

  No

  N/A

• Emergency Preparedness (First Extinguishers and first aid kits present, training, staffing employees included, etc.)

  Yes

  No

  N/A

• Open Door/Suggestion Box Policy

  Yes

  No

  N/A

• HAZCOM (Presence of SDS's, Training, etc.)

  Yes

  No

  N/A

• Hearing Conservation Exposures (HEaring protection, PPE, Training, Audiograms, etc.)

  Yes

  No

  N/A

• Any Confined Space Work (Permit or non permit required confide spaces)

  Yes

  No

  N/A

• Ladder Safety (Authorized employees only, program, training,

  Yes

  No

  N/A

• Work at Heights (Fall Protection)

  Yes

  No

  N/A

• Electrical (Frayed wiring, block electrical panel boxes. open circuits/boxes, temporary wiring use as permanent wiring)

  Yes

  No

  N/A

• Lock Out Tag Out [LOTO] (Affected Employee/Authorized Employees)

  Yes

  No

  N/A

• Forklift Operations (Staffing Employees operate fork lifts, Training Certification, battery changing procedures, Fuel change outs)

  Yes

  No

  N/A

• Eye Wash Stations

  Yes

  No

  N/A

• Storage Racks (Load Limits maintained)

  Yes

  No

  N/A

• Loading Docks (Dock Bay closed, Trailers Chocked, Loading Ramp Load Limit Appropriate)

  Yes

  No

  N/A

• Chris Abbs, Safety Manager - Recruit Specialized Staffing

  Sign

• Date & Time

  Date