Workplace Health & Safety Appraisal Document (E)WE 2

• Audit Title

• Document No.

Employer Details

• Employer Name:

• Address:

• Enter post code:
  Address

• Appraisal date:

  Date

• Employer contact:

• Telephone:

• Main occupational activity:

Overall Risk Rating

• Enter the occupational risk level

  Low Risk

  Medium Risk

  High Risk

• Enter the organisational risk

  Low Risk

  Medium Risk

  High Risk

• Enter Overall Risk:

  Select Low Risk Medium Risk High Risk

  • Low Risk
  • Medium Risk
  • High Risk

• Enter the period the appraisal is valid for:

  Select 3 years 2 years 1 year

  • 3 years
  • 2 years
  • 1 year

Mandatory Criteria

• Name of Supervisor:

• The supervisor is comptent to supervise the student?

  Yes

  No

• The supervisor is comptent because:

  Select Owner Training Manager Department Supervisor Manager Shift Supervisor Individual members of staff chosen by the employer as suitably competent to provide supervision

  • Owner
  • Training Manager
  • Department Supervisor
  • Manager
  • Shift Supervisor
  • Individual members of staff chosen by the employer as suitably competent to provide supervision

• If the supervisor is not present in work for any reason, is there a suitable comptent person available to provide supervision?

  Yes

  No

• If no suitable supervision is available, what arraingements are in place to ensure the student isn't put at risk

Employers Liability Insurance

• Is Employers Liability Insurance in place?

  Yes

  No

• Name of Insurance:

• Certificate Number:

• Enter Expiry Date

  Date

• Public Liability Insurance is in place:

  Yes

  No

  N/A

• Enter the amount insured for:

• If available take a photo of the ELI

  Media

Legal notifications

• The employer has registered with the relevent regulatory agency

  Select HSE Local Authority Ofsted Care Quality Commission Dentist N/A

  • HSE
  • Local Authority
  • Ofsted
  • Care Quality Commission
  • Dentist
  • N/A

• The employer has five or more employees

  Yes

  No

• The employer has a written Health and Safety Policy

  Yes

  No

  N/A

• The employer has formally recorded risk assessments

  Yes

  No

  N/A

• Are other young people employed at the organisation?

  Yes

  No

• Has the employer discussed the placement with a suitable member of college staff?

  Yes

  No

Mandatory Signage

• The employer has suitable mandatory signage displayed

  Yes

  No

Accident management

• The employer has a suitable person responsible for reporting RIDDOR'S

  Yes

  No

• The employer has

  suitable first aid provison

  no suitable first aid provison

Risk Management

• Suitable risk management systems have been witnessed

  Yes

  No

• If the answer is no, then the organisation must be rejected unless a suitable development plan is agreed with prohibitions or restrictions.

• The following additional evidence of risk management was witnessed

• Take pictures of suitable evidence

  Media

Fire Safety

• Suitable fire safety precautions are in place?

  Yes

  No

• Take pictures of suitable evidence

  Media

• The learner will only use work equipment under close supervision until passed as compent by the supervisor

• Sign this Field

  Sign

Development Plan

• The employer has been signposted to the HSE website for advice

  Yes

  No

• The employer requires a more indepth development plan

  yes

  no

• Enter detals of the development plan

• Add signature

  Sign