Information

  • Document No.

  • Client / Site

  • Address

  • Client Contact Name & Position

  • Conducted on

  • Prepared by

Systems / Policies / Contact

  • Name of Person/s responsible for WHS on site (Name & Location on site)

  • Does the client have a documented WHS management system?

  • Does the client have an Injury Management policy/program?

  • Does the client have a Bullying & Harassment policy/program?

  • Does the client have a Risk Management Program or Workplace Inspection Schedule in place?

  • Does the client have Hazard / Incident reporting forms or process? (EG: Accident, Injury, Near Miss forms, or reporting methods)

Consultation / Training

  • Does the client have WHS consultation arrangement in place? (EG OHS Committee / HSR / Other)

  • If WHS Committee is in place are minutes of meeting available to staff? (If possible sight and record location)

  • Are on hired staff put through client in house induction/training as well as Exacts induction? (If yes sight signed induction and list location)

  • Does the client have documented Safe Work Procedures (SWP) / Safe Operating Procedures (SOP) / Safe Work Method Statements (SWMS) or Work Instructions?

  • Do on hired staff sign a form after receiving necessary training required to perform task/job safely?

Injury / Incident / First Aid

  • Is there a dedicated Client contact who will report / inform Exact of any Injuries / Incidents or Near Misses? (List name & direct contact number if possible)

  • Is there a person trained First Aider onsite? (List name & Location)

  • Are First Aid kit / kits available and are they efficiently stocked?

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  • Are First Aid kits checked - service / maintained / refilled on a regular basis? (If yes list by whom)

  • Is there a First Aid register onsite for recording injuries / illnesses? (If yes list location)

  • Add media

Amenities

  • Are toilets clean and well stocked with toilet paper & soap?

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  • Are lockers or a safe areas provided for storing personal belongings?

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  • Is there access to clean drinking water?

  • Is there a dedicated lunchroom / kitchen or area for on hired staff to use during breaks? (If yes list)

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  • Are facilities for storing / heating food available? (EG Fridge / Microwave)

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Storage / Enviroment

  • Is there sufficient lighting?

  • Is environment temperature comfortable for on hired staff to complete work in? (EG Not overly hot or cold)

  • Are all walkways / isles / passageways clear of slip / trip / fall hazards? (EG Cords / Stock / Uneven Surfaces)

  • Are all walkways / isles / passageways free of any protrusions or obstructions at head height?

  • Is there adequate storage for plant, materials & stock onsite?

  • Does storage allow for safe retrieval of plant, materials & stock?

  • If ladders are used onsite are they Safety / Platform types?

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Emergency Provisions

  • Is there a building emergency evacuation plan available & displayed? (If yes list location)

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  • Are Emergency / Evacuation procedures available & displayed? (If yes list location)

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  • Do all emergency exits open outwards and are they kept unlocked?

  • Are all emergency exits clear of obstructions both inside & out?

  • Are all emergency exits clearly marked? (EG lights / floor markings etc)

  • Is there sufficient fire fighting equipment? (EG Extinguishers, Hose, Fire Blankets ETC)

  • Are fire extinguishers appropriate for the risks? (EG Water, Foam, Dry Chemical)

  • Are fire extinguishers stored with clear access and correct signage?

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  • Are fire extinguishers tested and tagged regularly? (Every 6 months) - (If yes list last tag date)

  • Are evacuation drills conducted? (If yes how often)

  • Are emergency telephone numbers listed & displayed? (If yes where are they displayed)

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Manual Handling

  • Does the client have a policy on maximum load a single person may lift? (If yes list maximum weight policy)

  • Will the maximum weight manual handled ever exceed 25kg and be a single man lift? (If yes please list max weight and item)

  • Are mechanical aids available which would minimise manual handling? (EG Trolleys, Pallet Jacks, Rollers) (If yes list)

  • Are loads moved over short distances only?

  • Are items / loads manually handled easy to get an adequate grip on?

  • Is there a need to handle bulky / awkward / slippery or unusual items? (If yes please list type or size)

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  • Will long periods of heavy / physical manual handling be required throughout a normal day? (Longer than 2hrs) (If yes list type & reason)

Forklifts

  • Is there a requirement for on-hired employees to drive/operate a forklift?

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  • Are the forklifts onsite owned by client?

  • Are the forklifts onsite leased by client? (If yes list leasing company)

  • What is there a service schedule on forklifts - EG Weekly / monthly / quarterly etc? (Please list schedule & approx. last month service was completed)

  • Are daily pre-operation checks conducted & documented on forklifts? (If yes sight where possible)

  • Is the workplace designed to separate pedestrians from forklift work areas? (If yes list how EG lines / barriers)

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  • Are warning devices such as flashing lights, beepers fitted on forklifts and are operational?

  • Is a roll bar fitted to forklift?

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  • Are seatbelts fitted to forklifts?

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  • Are forklifts speed limited? (If no are traffic management speed control signs in place)

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  • Are order-pickers (LO) forklifts used on this site?

  • Is order-picker forklift platform fully enclosed?

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  • Are safety harnesses provided & worn when order-picker is in operation?

Chemicals

  • Are chemicals other than household cleaners used / stored on site?

  • Are chemicals stored safely in a designated area on site?<br>

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  • Are all chemicals clearly labelled with appropriate warning signs displayed?

  • Are chemicals decanted in their designed containers? (As opposed to food or drink containers like coke bottles)

  • Are MSDS / SDS for all chemicals displayed or easily accessed by staff? (If yes list where)

  • Is all required PPE for safe handling of chemicals available / supplied to on-hired workers?

  • Are flammable materials stored in fireproof cabinets and approved containers?

  • Are flammable materials stored away from corrosive and oxidisers?

  • Are combustible stored in containers with metal lids?

  • Are spill kits available and well stocked?

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  • If corrosives are handled, is there an eyewash and safety shower readily accessible?

  • Is there a chemical register, listing the chemicals used onsite?

Personal Protective Equipment - PPE

  • Is PPE required on site? (If yes check below items)

  • Hi-Visibility top (Vest / Shirt / Jacket ETC)

  • Steel Toe / capped safety footwear

  • Protective clothing (Overalls / Long sleeves & pants)

  • Hand Protection (Gloves)

  • Eye Protection

  • Head Protection (Hard Hats ETC)

Hearing Protection

  • is Hearing Protection required to be worn onsite? (If yes please list type EG buds, muffs, headphones)

  • Is hearing protection supplied and easily available to staff? (If yes list where it is store/available)

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  • Have noise surveys been conducted of site?

  • Are hearing initial assessments given to all workers that work in areas they have to wear hearing protection within the first 3 months of employment?

  • Are hearing assessments completed every 2 years for workers in areas where they have to wear hearing protection?

Plant & Machinery

  • Will On Hired staff be required to operate / work on Plant / Machinery (Other than Forklifts / Pallet Jacks / Trolleys)? (If Yes please list type & brand below)

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  • Will On-Hired staff be given training on Plant / Machinery?

  • If training is given is the training documented? (Sight where possible)

  • Are SOP / SWP available for Plant / Machinery? (If yes list location)

  • Have adequate measures been put in place to eliminate or minimize hazards during Plant / Machinery usage? (If Yes please list)

  • Are Machines well guarded? (If yes list types of guards EG light curtain, sensor doors, manual guarding)

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  • Are guards fitted to all hazardous moving parts / trapping spaces & in good working order?

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  • Is area around Plant / Machinery clear, clean and free of trip/slip hazards?

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  • Are emergency stop buttons or lanyards fitted to machines?

  • Are emergency stops buttons easily identified and within clear reach of operator?

  • Will On Hired staff be required to operate machinery / equipment in isolation?

  • If Yes is there adequate provisions made for contact in case of emergency? (List)

Signatures

  • Client Company Representative

  • Person Whom Completed Workplace Safety Assessment

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