WHS Annual Assessment

Annual Safety Assessment

• Client / Site

• Conducted on

  Date

• Staff in Attendance

• Name of Safety and Wellbeing Assessor

Revised December 2014 Version Control V8.0

1.0 - RISK MANAGEMENT

• 1.1 - Are staff involved in:<br>. Identification of hazards<br>. Risk assessment process<br>. Incident reporting

  Yes

  No

  N/A

• 1.2 - Risks are assessed, controls are identified, implemented and monitored for effectiveness?<br>

  Yes

  No

  N/A

• 1.3 - Is there regular attendance at WH&S Committee Meeting<br>. Are the minutes communicated to all staff?<br>. Are unresolved risks identified through the quarterly inspection and escalated to the committee?<br><br>

  Yes

  No

  N/A

• 1.3.1 - Is a report page of a past quarterly inspection able to be viewed (where an issue was escalated to the committee)?

  Yes

  No

  N/A

• 1.4 - Are supervisors aware of incident reporting and investigation responsibilities?<br>

  Yes

  No

  N/A

• 1.5 - Is there a plan in place to manage contractors and suppliers, including identification to staff?<br><br>

  Yes

  No

  N/A

2.0 - WORK ENVIRONMENT

• 2.1 - Is an ACM register readily available for staff at the workplace and compliant signage to major entries where required?

  Yes

  No

  N/A

• 2.2 - Health surveillance and environmental monitoring is conducted where required? (Radiation badge?)

  Yes

  No

  N/A

• 2.3 - Are lighting and ventilation and noise perceived as adequate?

  Yes

  No

  N/A

• 2.4 - Are evacuation routes, passageways and work areas free from obstructions?

  Yes

  No

  N/A

• 2.5 - Are slip and trip hazards identified, controlled and monitored?

  Yes

  No

  N/A

• 2.6 - Is there an appropriate stand for duties/tasks requiring access above shoulder height?

  Yes

  No

  N/A

• 2.7 - Are items being stored appropriately?

  Yes

  No

  N/A

• 2.8 - Is patient handling equipment regularly serviced and maintained, and inspected?

  Yes

  No

  N/A

3.0 - EMERGENCY RESPONSE

• 3.1 - Is the following current:<br>. Evacuation drill<br>. Fire evacuation plan<br>. Evacuation diagrams<br>. Emergency wardens list

  Yes

  No

  N/A

• 3.2 - Does the work unit have appropriately maintained:<br>. Spills kit<br>. Emergency showers/eye wash?<br>

  Yes

  No

  N/A

• 3.2.1 - Date of last evacuation exercise?

  Date

• 3.3 - Is the work unit compliant with the requirements of the SCHHS first aid procedure?

  Yes

  No

  N/A

4.0 ELECTRICAL

• 4.1 - Is all electrical equipment tested, tagged and in date?

  Yes

  No

  N/A

• 6.1.1 - Items that require attention are:

• 4.2 - Are body protected and cardiac protected areas tested, tagged and in date?

  Yes

  No

  N/A

• 4.3 - Is there a procedure to ensure patients or staff do not plug in non-tested equipment?

  Yes

  No

  N/A

• 4.4 - Are power boards and electrical boards clear and easily accessible?

  Yes

  No

  N/A

5.0 HAZCHEM

• 5.1 - Have relevant staff been trained in how to use ChemALERT and aware how to access chemical risk assessment?

  Yes

  No

  N/A

• 5.2 - Is the ChemAlert stockholding list accurate and maintained?

  Yes

  No

  N/A

• 7.3.1 - Date of last ChemAlert stockholding audit?

  Date

• 5.3 - Are decanted substances contained in suitable containers and correctly labelled?

  Yes

  No

  N/A

• 5.4 - Are gas cylinders restrained and stored correctly?

  Yes

  No

  N/A

6.0 - HEALTHCARE ERGONOMICS

• 6.1 - Have staff who use the computer for more than 66% of their day completed the computer workstation self assessment checklist?

  Yes

  No

  N/A

• 6.2 - Do staff handle patients<br>. Has a FURAT been completed in the last 12 months?

  Yes

  No

  N/A

7.0 OCCUPATIONAL VIOLENCE AND SECURITY

• 7.1 - Is the VAMP (violence aggression mitigation prevention) assessment current? (re-assess every 2 years)

  Yes

  No

  N/A

• 7.2 - Have duress alarms been tested recently and a record maintained?

  Yes

  No

  N/A

• 9.3.1 - Date of last duress test

  Date

• 7.3 - Are risk assessments conducted on patients before off-site attendance?

  Yes

  No

  N/A

8.0 INFORMATION , INSTRUCTION, TRAINING AND SUPERVISION

• 8.1 - All staff trained in reliant levels of OVP?

  Yes

  No

  N/A

• 8.2 - Has the HSRS completed relevant education/training and is the identity of the HSR displayed at the workplace?

  Yes

  No

  N/A

• 8.3 -Is there a notice board for WH&S:<br>. Policy statement displayed<br>. WH&S Committee minutes<br>. Quarterlies?

  Yes

  No

  N/A

• 8.4 - Have all staff completed mandatory training to include:<br>. Fire training<br>. Manual handling<br>. Patient handling<br>Have training needs been identified:<br>. P.A.D.s

  Yes

  No

  N/A

• 8.5 - Has managers local induction checklist taken place and been documented for all staff including casuals and contractors?

  Yes

  No

  N/A

• 8.6 - Have staff completed the driver safety awareness program?

  Yes

  No

  N/A

• 8.7 -Are staff aware of and have information on fatigue management protocol?l

  Yes

  No

  N/A

SIGN OFF

• Sign off by Manager

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• Sign off by Health and Safety Representative/s (if relevant)

  Sign

• Sign off by Assessor

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