Information

  • Employee Working Alone

  • Designated Contact Person

  • Location
  • Conducted on

  • Prepared by

Timeframe

  • Start Time

  • Expected End Time

  • If expected duration is greater than 2 hours a check-in is required every 2 hours.

Hazard Inspection

  • Identify all hazard that may be encountered during the working alone period

  • Hazard
  • Hazard

  • Control

  • Is the hazard control in place?

Check-in Records

  • Worker will check in with designated contact at minimum every 2 hours and at end of working alone period

  • Check-In
  • Contact

  • Select date

  • Has the working alone period ended?

  • In the event the worker does not establish contact, the designated contact will try to establish contact with the worker (communication device). If unable to do so the designated contact will contact emergency services.

    Designated contact must not enter a confined space, or work area where the hazard has not been identified and controlled.

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. Any ratings or scores displayed in our Public Library have not been verified by SafetyCulture for accuracy. Users of our platform may provide a rating or score that is incorrect or misleading. You should independently determine whether the template is suitable for your circumstances. You can use our Public Library to search based on criteria such as industry and subject matter. Search results are based on their relevance to your search and other criteria. We may feature checklists based on subject matters we think may be of interest to our customers.