Rivergum Homes Visitor Induction Checklist

• Name

• Site Address

• Conducted on

  Date

• Prepared by

Visitor Induction

• As a Rivergum Homes visitor/client I am aware and have been given the opportunity to raise any issues with the following points:

• I must not enter the site unless accompanied by Rivergum Homes representative (not subcontractors)

  Yes

  No

  N/A

• I have been shown Rivergum Homes OH&S Policy Statement and had its contents discussed with me

  Yes

  No

  N/A

• I have been shown what to do in case of an emergency

  Yes

  No

  N/A

• I have been shown the location of the Emergency Assembly Point and Evacuation Route(s)

  Yes

  No

  N/A

• I have been instructed how to contact help whilst onsite

  Yes

  No

  N/A

• I have been instructed how to get treatment for an injury

  Yes

  No

  N/A

• I have been shown the location of the first aid facilities/kits and how to obtain treatment and/or assistance

  Yes

  No

  N/A

• I am not affected by drugs or alcohol

  Yes

  No

  N/A

• I have been instructed in what to do if I become separated

  Yes

  No

  N/A

• I do have correct PPE (hard hat/safety glasses/safety boots/long sleeve shirt/hi-vis vest)

  Yes

  No

  N/A

• I do know how to wear the PPE properly

  Yes

  No

  N/A

• I have been advised of the major hazards and no-go zones on the site

  Yes

  No

  N/A

• I have allergies, medical condition or other disability that may affect me during site walk through (If yes, Rivergum Homes representative should gain authorisation from WHS Manager prior to walk through)

  Yes

  No

  N/A

Rivergum Homes Pty Ltd takes Workplace Health and Safety seriously and requires all visitors to any site to do the same. Adhering to the Work Health and Safety Act 2011 and Regulations 2011 is of great importance to the builder and it will create a safer work place, free of injury and serious risk to all parties. The builder is required by legislation to ensure the safety of all persons entering the site who could be adversely affected by building activities. Therefore, by signing this induction, you confirm you have participated in the Visitor Induction during which you had the Site Specific Health & Safety Rules explained to you. You understand the importance of remaining with the site escort at all times and you agree to comply with these safety rules during your visit.

• Visitor Acknowledgment

  Sign

• Rivergum Homes Representative

  Sign