COVER

  • Document No.

  • Assessment title

  • Audit Title

  • Computer workstation location

  • Responsible department

  • Assessment date

  • Prepared by

USER DETAILS

COMPUTER USER DETAILS

  • Name

  • Work email

  • Work phone number

PLACE OF WORK

  • Department

  • Work location

  • Type of computer work performed

  • Relationship to University

  • Immediate line manager(s)
    (Manager who can action any recommendations)

  • line manager
  • Line manager

COMPUTER HISTORY

  • Has a computer workstation assessment been completed by the department

  • Suffered discomfort or problem working at this computer workstation

  • Suffered discomfort or ergonomic problem while working on another computer workstation

  • Suffering from a medical condition or complaint which needs to be taken into account in the assessment

  • Additional details of medical conditions and the effects these have

  • CONDITIONS
  • Medical condition details

ASSESSMENT DETAILS

COMPUTER DISPLAY SCREEN PERFORMANCE

  • Screen image is clear and readable

  • Screen image free from glare & reflections<br>(consider both artificial and natural light sources)

  • Blinds fitted to prevent screen glare & reflection and control contrast between screen & surroundings

  • Screen brightness & contrast can be adjusted by the computer user

  • Screen can swivel & tilt<br>(If the screen is a flat screen, then the ability to swivel is not usually important and can be ignored)

  • Screen specification suitable for the intended use

  • Notes
  • Notes

COMPUTER KEYBOARD

  • Keyboard can tilt to provide a sloped face

  • Keyboard characters are clear & readable

  • Keyboard keys are fully functioning

  • Notes
  • Notes

MOUSE OR EQUIVALENT DEVICE

  • Mouse suitable for the user and the tasks performed.<br>(Give due consideration the size of the mouse and the shape of the mouse relative to the users dominant hand)

  • Mouse works smoothly at a speed that suits the user and the tasks performed

  • Mouse settings can be adjusted for speed and responsivness

  • Notes
  • Notes

SEATING

  • The seat is in general good condition and intact

  • The seat has an adjustable height mechanism; the mechanism works and holds the seat at the desired height

  • The seat has a back support adjustable for height and tilt; the mechanisms work and hold the back support in the desired position

  • Seat arms can be adjusted for height and/or tilt

  • Seat swivels freely without sticking

  • Seat fitted with a five leg base equipped with castors or glides; castors and glides all work smoothly

  • Notes
  • Notes

FURNITURE

  • Work surface is large enough for the tasks commonly performed

  • Notes
  • Notes

COMPUTER SOFTWARE

  • Software is suitable for the tasks to be perfomed

  • Software can be used by the user

  • Notes
  • Notes

WORKING ENVIRONMENT

  • Lighting level suitable for the work undertaken

  • Temperature suitable for the work undertaken

  • Noise level suitable for the type of work undertyaken

  • Air quality satisfactory for the type of work undertaken

  • Notes
  • Notes

WORKING POSITION & WORKING PRACTICES

  • Sufficient space to change position during the working day

  • Chair adjusted correctly

  • Chair comfortable for the user

  • Chair supports small of the users back

  • Chair set to give a comfortable keying position

  • The top the screen is roughly eye level,<br>when the chair is adjusted correctly and the user is in a comfortable keying position, <br>

  • The feet can be placed flat on the floor (or flat on a foot rest),<br>when the chair is adjusted correctly and the user is in a comfortable keying position, <br>

  • There is support for the users forearm & wrist<br>when the chair is adjusted correctly and the user is in a comfortable keying position, <br>

  • The mouse is positioned within easy reach, as close to the users midline as possible

  • The user has regular changes of activity or breaks away from the computer<br>(about 10 minutes in each hour)

  • Notes
  • Notes

FINAL QUESTIONS

  • Are there any other factors that need to be taken into account by this assessment

  • User is aware of entitlement to periodic eyesight testing

  • Notes
  • Notes

SIGNATURES

  • Assessor

  • Workstation user

  • Others present

  • others present
  • Others present

RECOMMENDATIONS

  • The following recommendations are made to remedy the problems found during the assessment

  • Enter recommendations

  • recommendation
  • Recommendation title

  • Action to be taken

  • Recommendation for

  • Deadline for completion

  • Recommendations made by

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.