TM Field Companion

• Engineer details (**payroll number must be included**)

• Prepared by

• Conducted on

  Date

• Visit Type

  Select HomeSafe RTW Customer Visit Damage Claim Investigation Coaching Equipment Inspection Item Drop Off/ Pick Up 121 ROD

  • HomeSafe
  • RTW
  • Customer Visit
  • Damage Claim
  • Investigation
  • Coaching
  • Equipment Inspection
  • Item Drop Off/ Pick Up
  • 121
  • ROD

TM RISK ASSESSMENT

• Are there any hazards?

  Yes

  No

• Are hazards controllable?

  Yes

  No

• Details

• Visit type

  Select HomeSafe RTW Customer Visit Damage Claim Investigation Coaching Equipment Inspection Item Drop Off/ Pick Up 121 ROD

  • HomeSafe
  • RTW
  • Customer Visit
  • Damage Claim
  • Investigation
  • Coaching
  • Equipment Inspection
  • Item Drop Off/ Pick Up
  • 121
  • ROD

HOMESAFE

• Job No

• Job type

  Select Service Install Install (multi-screen) MHO MHO (multi-screen) Other

  • Service
  • Install
  • Install (multi-screen)
  • MHO
  • MHO (multi-screen)
  • Other

• Observation

  Announced

  Unannounced

• Is the engineer working safely on arrival?

  Yes

  No

• Risk Assessment

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety.

• Manual Handling

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• PPE

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Damage Awareness

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Working at Height

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Ladder type

  Select No Ladder Step/ Combi Single Section Double Section Triple Section CAT DAT SAT (inc rope access)

  • No Ladder
  • Step/ Combi
  • Single Section
  • Double Section
  • Triple Section
  • CAT
  • DAT
  • SAT (inc rope access)

• How was Combi- ladder used?

  A Frame (0 extension)

  A Frame (2 rung extension)

  A Frame (3 rung extension)

  A Frame (4 rung extension)

  Triple extension ladder

• Record of findings (Equipment set up and description of job as was carried out. Highlight positive aspects of work witnessed)

• Add pictures to support observation (inc RAMS forms if applicable)

  Media

• Additional HomeSafe on this visit

• Job No

• Job type

  Select Service Install Install (multi-screen) MHO MHO (multi-screen) Other

  • Service
  • Install
  • Install (multi-screen)
  • MHO
  • MHO (multi-screen)
  • Other

• Risk Assessment

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Manual Handling

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• PPE

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Damage Awareness

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Working at Height

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Ladder type

  Select No Ladder Step/ Combi Single Section Double Section Triple Section CAT DAT SAT (inc rope access)

  • No Ladder
  • Step/ Combi
  • Single Section
  • Double Section
  • Triple Section
  • CAT
  • DAT
  • SAT (inc rope access)

• Record of findings (Equipment set up and description of job as was carried out. Highlight positive aspects of work witnessed)

• Add pictures to support observation (inc RAMS forms if applicable)

  Media

• Additional HomeSafe on this visit

• Job No

• Job type

  Select Service Install Install (multi-screen) MHO MHO (multi-screen) Other

  • Service
  • Install
  • Install (multi-screen)
  • MHO
  • MHO (multi-screen)
  • Other

• Risk Assessment

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Manual Handling

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• PPE

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Damage Awareness

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Working at Height

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Ladder type

  Select No Ladder Step/ Combi Single Section Double Section Triple Section CAT DAT SAT (inc rope access)

  • No Ladder
  • Step/ Combi
  • Single Section
  • Double Section
  • Triple Section
  • CAT
  • DAT
  • SAT (inc rope access)

• Record of findings (Equipment set up and description of job as was carried out. Highlight positive aspects of work witnessed)

• Add pictures to support observation (inc RAMS forms if applicable)

  Media

• Additional HomeSafe on this visit

• Job No

• Job type

  Select Service Install Install (multi-screen) MHO MHO (multi-screen) Other

  • Service
  • Install
  • Install (multi-screen)
  • MHO
  • MHO (multi-screen)
  • Other

• Risk Assessment

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Manual Handling

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• PPE

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Damage Awareness

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Working at Height

  Safe

  Unsafe

  Not Witnessed

• Details

• Open 'Coaching' section to record coaching safety

• Ladder type

  Select No Ladder Step/ Combi Single Section Double Section Triple Section CAT DAT SAT (inc rope access)

  • No Ladder
  • Step/ Combi
  • Single Section
  • Double Section
  • Triple Section
  • CAT
  • DAT
  • SAT (inc rope access)

• Record of findings (Equipment set up and description of job as was carried out. Highlight positive aspects of work witnessed)

• Add pictures to support observation (inc RAMS forms if applicable)

  Media

RTW

• Type of absence

  Short Term Sickness

  Long Term Sickness

  Paid/Authorised Absence

  Unpaid/Unauthorised Absence

• First day of absence

  Date

• Last day of absence

  Date

• Absence reason

  Select Alcohol/ Drug addition Allergy Asthma (excl work related) Blood disorder Breast problems Cancer/ Tumors Chest/ Respiratory problems Cold/ Cough/ Flu/ Influenza Dental Diabetes/ Thyroid/ Endocrine Disease of nervous system Ear/ Nose/ Throat condition Epilepsy or Neurological Eye problem Gastrointestinal problems Gynae including period pains Headache/ Migraine Heart/ BP/ Cirulatory Infectious disease Kidney/ Bladder problem Non work Injury/ Burn/ Fracture/ RTA Non work Musculoskeletal problem Non work Back/ Disc problem Occupational Asthma Occupational Dermatitis Pregnancy related Scheduall Sickness code Stess/ Anxiety/ Depression (non work) Stess/ Anxiety/ Depression (work related) Swine flu Unknown cause Vertigo/ Dizziness/ Insomnia Virus Work Injury/ Burn/ Fracture/ RTA Work related Musculoskeletal problem Work related Back/ Disc problem Other

  • Alcohol/ Drug addition
  • Allergy
  • Asthma (excl work related)
  • Blood disorder
  • Breast problems
  • Cancer/ Tumors
  • Chest/ Respiratory problems
  • Cold/ Cough/ Flu/ Influenza
  • Dental
  • Diabetes/ Thyroid/ Endocrine
  • Disease of nervous system
  • Ear/ Nose/ Throat condition
  • Epilepsy or Neurological
  • Eye problem
  • Gastrointestinal problems
  • Gynae including period pains
  • Headache/ Migraine
  • Heart/ BP/ Cirulatory
  • Infectious disease
  • Kidney/ Bladder problem
  • Non work Injury/ Burn/ Fracture/ RTA
  • Non work Musculoskeletal problem
  • Non work Back/ Disc problem
  • Occupational Asthma
  • Occupational Dermatitis
  • Pregnancy related
  • Scheduall Sickness code
  • Stess/ Anxiety/ Depression (non work)
  • Stess/ Anxiety/ Depression (work related)
  • Swine flu
  • Unknown cause
  • Vertigo/ Dizziness/ Insomnia
  • Virus
  • Work Injury/ Burn/ Fracture/ RTA
  • Work related Musculoskeletal problem
  • Work related Back/ Disc problem
  • Other

• Please state reasons

• Is the absence work related?

  Yes

  No

• Details

• Was this a linked absence?

  Yes

  No

• Details

• Did engineer visit a GP during their absence?

  Yes

  No

• Is this absence over 7 days?

  Yes

  No

• In line with the company absence policy if the absence is over 7 days the employee must provide a 'Fit to Work' certificate in order for a full return to work.

• Has a 'Fit to Work' note been provided?

  Yes

  No

• Add any pictures of 'Fit To Work' certificates

  Media

• Is this absence over 7 days?

  Yes

  No

• In line with the company absence policy if the absence is over 7 days the employee must provide a 'Fit to Work' certificate in order for a full return to work.

• Is the engineer currently on any medication?

  Yes

  No

• Details of medication

• Number of absences in rolling 12 months?

  Select 0 (first absence) 1 2 3 4 5 6 7 8 9 10+

  • 0 (first absence)
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10+

• How many?

• Percentage absence in rolling 12 months?

  0 - 1.59%

  1.6 - 3.59%

  3.6 - 5.59%

  5.6 - 8.49%

  8.5% +

• Has this absence triggered further action?

  Yes

  No

• Process Triggered?

  Informal Discussion

  Attendance Hearing

• Occupational Heath referral required?

  Yes

  No

• Date of referral/ planned referral

  Date

• Additional information

• If the returning Engineer has been off 28 days or more please refer to the RTWL in the first instance before a full return to work

• Reason for Absence

• Any follow up considerations?

Reopen Visit Type and include 'ROD' if required

CUSTOMER VISIT

• Job No

• Customer Visit type

  Engineer on site

  Post engineer visit

• Has a HomeSafe observation been completed?

  Yes

  No

• Reason for no HomeSafe observation

• Customers additional services

  Select On Demand Sky Go Remote Record Active 'My Sky'

  • On Demand
  • Sky Go
  • Remote Record
  • Active 'My Sky'

• Record of findings (Quality of work, Customer satisfaction etc)

• Add pictures to support findings

  Media

• Additional 'Customer Visits' on this visit

• Job No

• Has a HomeSafe observation been completed?

  Yes

  No

• Reason for no HomeSafe observation

• Customers additional services

  Select On Demand Sky Go Remote Record Active 'My Sky'

  • On Demand
  • Sky Go
  • Remote Record
  • Active 'My Sky'

• Record of findings (Quality of work, Customer satisfaction etc)

• Add pictures to support findings

  Media

• Additional 'Customer Visits' on this visit

• Job No

• Has a HomeSafe observation been completed?

  Yes

  No

• Reason for no HomeSafe observation

• Customers additional services

  Select On Demand Sky Go Remote Record Active 'My Sky'

  • On Demand
  • Sky Go
  • Remote Record
  • Active 'My Sky'

• Record of findings (Quality of work, Customer satisfaction etc)

• Add pictures to support findings

  Media

• Additional 'Customer Visits' on this visit

• Job No

• Has a HomeSafe observation been completed?

  Yes

  No

• Reason for no HomeSafe observation

• Customers additional services

  Select On Demand Sky Go Remote Record Active 'My Sky'

  • On Demand
  • Sky Go
  • Remote Record
  • Active 'My Sky'

• Record of findings (Quality of work, Customer satisfaction etc)

• Add pictures to support findings

  Media

• Job no

• Date of engineer visit

  Date

Customer Q&A

• Did the engineer arrive within the set ETA? 1

  Yes

  No

• Did the engineer keep you updated?

  Yes

  No

• Did the engineer to through the job with you before starting?

  Yes

  No

• Comments

• Did the engineer go through the job after completion?

  Yes

  No

• Comments

• Was there anything more the engineer could've done for you?

  Yes

  No

• Comments

• Did the visit enhance your perception of Sky?

  Yes

  No

• Comments

• As a business was there anything more we could've done for you?

  Yes

  No

• Comments

• Additional comments about the visit

• Evidence of H&S usage?

  Yes

  No

• Job Type

  Select Service Install Install (multi-screen) MHO MHO (multi-screen) Other

  • Service
  • Install
  • Install (multi-screen)
  • MHO
  • MHO (multi-screen)
  • Other

• Is further investigation required?

  Yes

  No

• Why not?

• Explanation of findings

• Add pictures to support findings

  Media

• Job Type

  Select Service Install Install (multi-screen) MHO MHO (multi-screen) Other

  • Service
  • Install
  • Install (multi-screen)
  • MHO
  • MHO (multi-screen)
  • Other

• Record of findings (Quality of work, Customer satisfaction etc)

• Add pictures to support findings

  Media

Reopen Visit Type and include 'ROD' if required

• Additional 'Post Checks' on this visit

• Job no

• Date of engineer visit

  Date

Customer Q&A

• Did the engineer arrive within the set ETA? 2

  Yes

  No

• Did the engineer keep you updated?

  Yes

  No

• Did the engineer to through the job with you before starting?

  Yes

  No

• Comments

• Did the engineer go through the job after completion?

  Yes

  No

• Comments

• Was there anything more the engineer could've done for you?

  Yes

  No

• Comments

• Did the visit enhance your perception of Sky?

  Yes

  No

• Comments

• As a business was there anything more we could've done for you?

  Yes

  No

• Comments

• Additional comments about the visit

• Evidence of H&S usage?

  Yes

  No

• Job Type

  Select Service Install Install (multi-screen) MHO MHO (multi-screen) Other

  • Service
  • Install
  • Install (multi-screen)
  • MHO
  • MHO (multi-screen)
  • Other

• Is further investigation required?

  Yes

  No

• Why not?

• Explanation of findings

• Add pictures to support findings

  Media

• Job Type

  Select Service Install Install (multi-screen) MHO MHO (multi-screen) Other

  • Service
  • Install
  • Install (multi-screen)
  • MHO
  • MHO (multi-screen)
  • Other

• Record of findings (Quality of work, Customer satisfaction etc)

• Add pictures to support findings

  Media

Reopen Visit Type and include 'ROD' if required

• Additional 'Post Checks' on this visit

• Job no

• Date of engineer visit

  Date

Customer Q&A

• Did the engineer arrive within the set ETA? 3

  Yes

  No

• Did the engineer keep you updated?

  Yes

  No

• Did the engineer to through the job with you before starting?

  Yes

  No

• Comments

• Did the engineer go through the job after completion?

  Yes

  No

• Comments

• Was there anything more the engineer could've done for you?

  Yes

  No

• Comments

• Did the visit enhance your perception of Sky?

  Yes

  No

• Comments

• As a business was there anything more we could've done for you?

  Yes

  No

• Comments

• Additional comments about the visit

• Evidence of H&S usage?

  Yes

  No

• Job Type

  Select Service Install Install (multi-screen) MHO MHO (multi-screen) Other

  • Service
  • Install
  • Install (multi-screen)
  • MHO
  • MHO (multi-screen)
  • Other

• Is further investigation required?

  Yes

  No

• Why not?

• Explanation of findings

• Add pictures to support findings

  Media

• Job Type

  Select Service Install Install (multi-screen) MHO MHO (multi-screen) Other

  • Service
  • Install
  • Install (multi-screen)
  • MHO
  • MHO (multi-screen)
  • Other

• Record of findings (Quality of work, Customer satisfaction etc)

• Add pictures to support findings

  Media

Reopen Visit Type and include 'ROD' if required

• Additional 'Post Checks' on this visit

• Job no

• Date of engineer visit

  Date

Customer Q&A

• Did the engineer arrive within the set ETA? 4

  Yes

  No

• Did the engineer keep you updated?

  Yes

  No

• Did the engineer to through the job with you before starting?

  Yes

  No

• Comments

• Did the engineer go through the job after completion?

  Yes

  No

• Comments

• Was there anything more the engineer could've done for you?

  Yes

  No

• Comments

• Did the visit enhance your perception of Sky?

  Yes

  No

• Comments

• As a business was there anything more we could've done for you?

  Yes

  No

• Comments

• Additional comments about the visit

• Evidence of H&S usage?

  Yes

  No

• Job Type

  Select Service Install Install (multi-screen) MHO MHO (multi-screen) Other

  • Service
  • Install
  • Install (multi-screen)
  • MHO
  • MHO (multi-screen)
  • Other

• Is further investigation required?

  Yes

  No

• Why not?

• Explanation of findings

• Add pictures to support findings

  Media

• Job Type

  Select Service Install Install (multi-screen) MHO MHO (multi-screen) Other

  • Service
  • Install
  • Install (multi-screen)
  • MHO
  • MHO (multi-screen)
  • Other

• Record of findings (Quality of work, Customer satisfaction etc)

• Add pictures to support findings

  Media

Reopen Visit Type and include 'ROD' if required

DAMAGE CLAIM

• Claim Ref No (Provided by Field Escalation Team)

• Job No

• Customer Details

• Date of engineer visit

  Date

• Nature of incident/ allegation reported

• Record of findings

• Do we accept liability?

  Yes

  No

• H&S Dept notified?

  Yes

  No

• What action is to be taken to resolve or repair?

• Has the person reported been made aware of the incident?

  Yes

  No

• Were there any witnesses?

  Yes

  No

• Witness details

• What corrective action has been taken to prevent a recurrence?

• Is further investigation required?

  Yes

  No

• Who will be investigating?

• Add pictures to support findings

  Media

Reopen Visit Type and include 'ROD' if required

INVESTIGATION

• Explanation of investigation (Reasons and findings)

• Add pictures to support investigation

  Media

• Is the engineer present?

  Yes

  No

I certify that I attended an investigation meeting and will not disclose to any third party the information discussed at this meeting (other than for the purposes of seeking legal advice). Please note that any breach of this agreement may result in action under the company's disciplinary procedure.

• Engineer

  Sign

• Firstly, thank you for meeting me. Before we go any further you've signed the confidentiality agreement which I remind you means that you cannot discuss the content of this meeting with anyone.
  
  I am currently conducting an investigation and I would like to ask you some questions.
  Please be as open and honest as you can because it's important to me that I am able to gather all the facts.
  You should be aware that the notes from this discussion we have today may be used going forward in any formal process. This means that these notes may be provided to other employees who have been involved in the situation, if necessary to do so.

Reopen Visit Type to include 'ROD'

Reopen Visit Type and include 'ROD' if required

COACHING

• Reason for coaching

  Select NPS Technical Customer Service Quality Safety Other

  • NPS
  • Technical
  • Customer Service
  • Quality
  • Safety
  • Other

• Pre visit comments

• Coach on site observations/ comments

• Engineer on site comments - What will you take away from today's session?

• Follow up details (if required)

• Review date

  Date

EQUIPMENT INSPECTION v12

TAG COLOUR - GREEN (April/May 14)

THIS IS A STAND ALONE FORM AND SHOULD NOT BE USED ALONG SIDE ANY OTHER SECTION OF THIS DOCUMENT

Harness/ Cows Tail Life - 7 years from FIRST USE or 10 years from date of manufacture

• Harness

  Fit for use

  Not fit for use (replacement to be ordered)

• Harness Serial no/ Date

• Cows Tail

  Fit for use

  Not fit for use (replacement to be ordered)

• Cows Tail Serial no/ Date

Kermantle Rope/ Retractable Safety Line Life - 5 years from FIRST USE or 10 years from manufacture

• 15M Rope

  Fit for use

  Not fit for use (replacement to be ordered)

• 15M Rope Serial no/ Date

• 10M Rope

  Fit for use

  Not fit for use (replacement to be ordered)

• 10M Serial no/ Date

• 5M Rope

  Fit for use

  Not fit for use (replacement to be ordered)

• 5M Serial no/ Date

• Retractable Safety Line

  Fit for use

  Not fit for use (replacement to be ordered)

• Retractable Safety Line Serial no/ Date

• Rope Grab

  Fit for use

  Not fit for use (replacement to be ordered)

• Reusable Eyebolts

  Fit for use

  Not fit for use (replacement to be ordered)

• Continuous Loop Webbing Sling

  Fit for use

  Not fit for use (replacement to be ordered)

• Continuous Loop Webbing Slings Quantity

  1

  2

  3

  4

  5

• Continuous Loop Webbing Sling Serial no/ Dates

• Adjustable (ratchet) Webbing Strap

  Fit for use

  Not fit for use (replacement to be ordered)

• Adjustable (ratchet) Webbing Straps Quantity

  1

  2

  3

  4

  5

• 10M Blue Strap with Ratchet

  Fit for use

  Not fit for use (replacement to be ordered)

• Karibeeners

  Fit for use

  Not fit for use (replacement to be ordered)

Chimney Strop Life - 8 years from FIRST USE

• Chimney Strop

  Fit for use

  Not fit for use (replacement to be ordered)

• Chimney Strop Serial no/ Date

• Soft Slings (part of chimney kit)

  Fit for use

  Not fit for use (replacement to be ordered)

• Microlite

  Fit for use

  Not fit for use (replacement to be ordered)

• Ladder Mate

  Fit for use

  Not fit for use (replacement to be ordered)

• Ladder Spike

  Fit for use

  Not fit for use (replacement to be ordered)

• Gravel Bag

  Fit for use

  Not fit for use (replacement to be ordered)

• Cones X2

  Fit for use

  Not fit for use (replacement to be ordered)

• Crawl Boards X2

  Fit for use

  Not fit for use (replacement to be ordered)

• 10mm Eyebolts

  Fit for use

  Not fit for use (replacement to be ordered)

• 10mm Eyebolt Quantity

  1

  2

  3

  4

  5

• 12mm Eyebolts

  Fit for use

  Not fit for use (replacement to be ordered)

• 12mm Eyebolt Quantity

  1

  2

  3

  4

  5

• 20mm

  Fit for use

  Not fit for use (replacement to be ordered)

• 20mm Eyebolt Quantity

  1

  2

  3

  4

  5

Hard Hat Life - 5 years

• Hard Hat

  Fit for use

  Not fit for use (replacement to be ordered)

• Hard Hat date

• Ladders

  12 Rung Fit for use

  12 Rung Not fit for use (replacement to be ordered)

  14 Rung Fit for use

  14 Rung Not fit for use (replacement to be ordered)

• Step Ladder/ Combi Ladder

  Fit for use

  Not fit for use (replacement to be ordered)

• CAT Ladder

  Fit for use

  Not fit for use (replacement to be ordered)

• Ear Protection

  Fit for use

  Not fit for use (replacement to be ordered)

• Goggles

  Fit for use

  Not fit for use (replacement to be ordered)

• Knee Pads

  Fit for use

  Not fit for use (replacement to be ordered)

• Manual Handling Gloves

  Fit for use

  Not fit for use (replacement to be ordered)

• Hi-Viz Vest

  Fit for use

  Not fit for use (replacement to be ordered)

• Dust Masks

  Fit for use

  Not fit for use (replacement to be ordered)

• Boots

  Fit for use

  Not fit for use (replacement to be ordered)

• SPECIALIST ENGINEER

DAT/ SAT Only

• 50M Rope

  Fit for use

  Not fit for use (replacement to be ordered)

• 50M Rope Serial no/ Date

• Rocker

  Fit for use

  Not fit for use (replacement to be ordered)

• Rocker Serial no/ Date

• Safety Ascender/Descender Device

  Fit for use

  Not fit for use (replacement to be ordered)

• 30M x 7mm Static ACC. Cord

  Fit for use

  Not fit for use (replacement to be ordered)

• Axel Belay Device

  Fit for use

  Not fit for use (replacement to be ordered)

• Wire Rope Slings

  Fit for use

  Not fit for use (replacement to be ordered)

• Delta Maillon

  Fit for use

  Not fit for use (replacement to be ordered)

• Rope Protecters

  Fit for use

  Not fit for use (replacement to be ordered)

• Pulley Blocks (fixed sheave)

  Fit for use

  Not fit for use (replacement to be ordered)

• RGH16 Harness (life same as DTH)

  Fit for use

  Not fit for use (replacement to be ordered)

• RGH16 Serial no/ Date

• Silverstar Helmet

  Fit for use

  Not fit for use (replacement to be ordered)

• Silverstar Helmet Serial no/ Date

• 8 Rung Extension Ladder

  Fit for use

  Not fit for use (replacement to be ordered)

• Ladder Clamp

  Fit for use

  Not fit for use (replacement to be ordered)

• Conservatory Bearer Bar X2

  Fit for use

  Not fit for use (replacement to be ordered)

• CAMP 30ltr Kit Bag

  Fit for use

  Not fit for use (replacement to be ordered)

• NOTE - If any items are found to be defective they are to be isolated and replaced as soon as possible.

ENGINEER DECLARATION: I confirm that by signing below the listed equipment has been issued to and is used by me. That no other equipment is used without authorisation, and a full inspection has been carried out by the HS&S - PPE & Equipment Examiner.

ITEM DROP OFF/ PICK UP

• Job No (if applicable)

• Details of item

• Is engineer working safely?

  Yes

  No

• Is further investigation required?

  Yes

  No

• Why?

Reopen Visit Type and include 'ROD' if required

• Add pictures to support document

  Media

121

• Reason for 121

  Select Praise/ Reward NPS Revisits Customer Service Technical Business Update DriveSafe Personal Matter Other

  • Praise/ Reward
  • NPS
  • Revisits
  • Customer Service
  • Technical
  • Business Update
  • DriveSafe
  • Personal Matter
  • Other

• Current NPS YTD

  Select Below 65 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100

  • Below 65
  • 65
  • 66
  • 67
  • 68
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• Current revisit KPI % YTD

  Select Over 5 4.1 - 5 3.1 - 4 2.1 - 3 1.1 - 2 0.1 - 1 0

  • Over 5
  • 4.1 - 5
  • 3.1 - 4
  • 2.1 - 3
  • 1.1 - 2
  • 0.1 - 1
  • 0

• Details

• Engineer comments

Reopen Visit Type and include 'ROD' if required

• Add pictures to support 121

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ROD

• Reason for ROD

• Time and date of incident

  Date

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If more text boxes are needed please start a new ROD form

• Is further action required? (Last ROD page only)

• Has this ROD resulted in a suspension from duty?

  Yes

  No

• For the reasons discussed today you are now suspended from the work place on full pay until these matters can be fully investigated. In the first instance you will be suspended until -

  Date

• This matter will be kept confidential. If necessary your colleagues will be informed that your absence is for personal reasons.
  
  In the meantime we may need to talk to you about this issue during your suspension so you should be available for contact and to attend meetings if necessary during your normal working hours. You will be advised of the outcome of the investigation as soon as possible.
  
  Should you for any reason need to speak to one of your work colleagues or to come into your place of work you should contact me in the first instance for prior authorisation.
  
  If you would like any advice or guidance in relation to company polices or processes during your period of suspension please contact GHR.

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Email a copy of this document to: admin.laserfiche@bskyb.com, yourself and your Regional Manager. Ensure you enter the engineers payroll number in the subject line. Your copy can be stored in your iBooks on your iPad for future reference (see iAuditor 'how to' for support)