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Audit

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.

Working Alone Assesment Checklist

Created by: B.Rocke Landscaping | Industry: Horticultural | Downloads: 116

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Audit

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.