Working from Home v1.0

• Employee

• Conducted on

  Date

• Prepared by

• Signature

  Sign
• Location
  Address

Designated work area

• Before a council approves the employee to work from home, an inspection should take place of the home based worksite. The inspection should be carried out by a competent person, using an inspection checklist.

Environmental conditions

Lighting

• Is there adequate lighting?

  Yes

  No

  N/A

• Can glare or reflection be controlled?

  Yes

  No

  N/A

Path of travel

• Are walkways and exit paths free of trip hazards or clutters?

  Yes

  No

  N/A

• Are there any electrical cables traversing across walkways?

  Yes

  No

  N/A

General Environment

• Is the environment smoke free?

  Yes

  No

  N/A

• Is there adequate ventilation?

  Yes

  No

  N/A

• Are there animals within the premises which may cause allergy (e.g. to another employee coming to visit the employee) or trip hazards?

  Yes

  No

  N/A

• Is there adequate cooling?

  Yes

  No

  N/A

• Is there adequate heating?

  Yes

  No

  N/A

• Is the environment free of other hazards e.g. mould, odours, noise etc.?

  Yes

  No

  N/A

• Are the premises clean and tidy?

  Yes

  No

  N/A

• Is the work area separate from other areas?

  Yes

  No

  N/A

• Are there other hazards present e.g. mats, furniture, stairs, slippery or broken tiles, ripped or worn carpet etc. which may cause trips or falls?

  Yes

  No

  N/A

Security

• Can the employee secure entry/exit points to prevent unauthorised access? (Review doors and windows.)

  Yes

  No

  N/A

• Can the work area be secured when not in use?

  Yes

  No

  N/A

First Aid

• Is there a first aid kit on site?

  Yes

  No

  N/A

• Does the employee have relevant first aid training?

  Yes

  No

  N/A

• Are the contents of the kit suitable?

  Yes

  No

  N/A

• Are the contents of the kit current?

  Yes

  No

  N/A

Emergency Procedures

• Is there a properly maintained dry chemical or carbon dioxide fire extinguisher or fire blanket on site?

  Yes

  No

  N/A

• Is the distance within walkways satisfactory to exit the premises expediently in the event of an emergency?

  Yes

  No

  N/A

• Is the walkway to the nearest exist sufficiently wide enough and free from hazards?

  Yes

  No

  N/A

• Is there a working smoke detector present near the work area?

  Yes

  No

  N/A

• Does the employee know the contact within council to call if there is an emergency?

  Yes

  No

  N/A

Electrical

• Is the equipment to be used in a well maintained and usable state?

  Yes

  No

  N/A

• Are there surge protector power boards for the equipment’s use?

  Yes

  No

  N/A

• Is there a circuit breaker or main power board safety switch present?

  Yes

  No

  N/A

• Are all power leads that are to be used in good condition?

  Yes

  No

  N/A

• Has all electrical equipment been tagged and tested in accordance with legislation?

  Yes

  No

  N/A

• Are all any overloaded power boards or adapters?

  Yes

  No

  N/A

Ergonomics

• Have instructions been provided regarding repetitive tasks and the requirement to take regular breaks? This includes breaks from looking at the computer screen for extended periods of time.

  Yes

  No

  N/A

• Are all tasks involving lifting, pushing, carrying etc. within the physical capability of the employee concerned?

  Yes

  No

  N/A

Chair

• Is the chair ergonomically designed?

  Yes

  No

  N/A

• Do the arm rest interfere with desk height or typing?

  Yes

  No

  N/A

• Is the chair adjustable?

  Yes

  No

  N/A

• Does the chair have a lumbar support?

  Yes

  No

  N/A

• Is the chair is on castors?

  Yes

  No

  N/A

• Does the chair have a five star base?

  Yes

  No

  N/A

• Is the back rest is adjustable?

  Yes

  No

  N/A

• Is the seat pan is tilt adjustable?

  Yes

  No

  N/A

• Has a foot rest been provided or necessary?

  Yes

  No

  N/A

• Has the employee been provided with instructions on correct posture and use of office equipment whilst working?

  Yes

  No

  N/A

Keyboard and Mouse

• Does the keyboard rest flat on the desk?

  Yes

  No

  N/A

• Is the mouse is located near the keyboard?

  Yes

  No

  N/A

• Is the distance from the mouse and the keyboard to the user is suitable?

  Yes

  No

  N/A

• Is the mouse type is suitable to the employee?

  Yes

  No

  N/A

Monitor

• Is the actual distance between the monitor and the user approximately 350mm - 750mm away?

  Yes

  No

  N/A

• Does the monitor sit slightly lower than the user’s eye level?

  Yes

  No

  N/A

• Is the monitor and keyboard directly in from of the user and equal distance from each side?

  Yes

  No

  N/A

• Is the monitor away from glare?

  Yes

  No

  N/A

Desk

• Is the desk large enough for the tasks to be carried out? Review placement of telephone and commonly used items in relation to user.

  Yes

  No

  N/A

• Is there sufficient space under the desk so that the users legs do not touch the under part of the desk?

  Yes

  No

  N/A

• Are there any sharp corners on the desk?

  Yes

  No

  N/A

• Is there sufficient space under the desk to allow the user to stretch their legs?

  Yes

  No

  N/A

• Is there a draw area for stationary and other sundry items?

  Yes

  No

  N/A

Lighting

• Is there adequate lighting?

  Yes

  No

  N/A

Work Practices

Hazard and incident reporting

• Does the employee know how to report a hazard or incident and by what method and to whom?

  Yes

  No

  N/A

Communication methods

• Has a communication process been established between the employee and employee to ensure the employees safety at regular periods?

  Yes

  No

  N/A

• Has the employee been provided with a listing of emergency contact details and numbers? These should include work contacts, police, fire, ambulance, nearest medical centre etc.

  Yes

  No

  N/A

• Does the council have a current emergency contact list from the employee, in the event of an emergency (which lists family or friends to contact in the event the employee is injured)?

  Yes

  No

  N/A

Fitness for work and any current medical conditions

• Is the employee fit enough to carry out the required tasks?

  Yes

  No

  N/A

• Has the employee disclosed any current or known medical conditions which may impact on their duties or when working at home (in isolation)?

  Yes

  No

  N/A

Special Requirements

• Are there any other special requirements which need to be considered for the employee to carry out their duties?

  Yes

  No

  N/A

Other Considerations

• Will there be any other person that is usually present whilst the employee carries out their work tasks at home? E.g. child etc.

  Yes

  No

  N/A