Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Company name
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Nature of business
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Business address
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Tel no.
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Email address
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Contact name
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Position
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Name of student
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Employer/public liability insurance.
Please enter details below or email a copy to xxxxxxx@leedscitycollege.ac.uk -
Insurer name
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Policy number
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Expiry date
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Health and Safety policy
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Do you have a health and safety policy
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Is there a clear commitment to health, safety and welfare?
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Induction
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Will the provider complete an introduction into the workplace ?<br>This should include: <br>- Going through the risk assessment for the workplace. If it is not written down, identifying the hazards of the environment. <br>- Accident and emergency procedures.<br>- Any machinery which is to be used and the appropriate training. <br>- How young people are considered in the arrangements and the additional controls if relevant.
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Does the employer provide ongoing health and safety information and training?<br>
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Supervision/Safeguarding
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Name of identified Supervisor or person with overall responsibility of the learner:
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Will the employer contact the college if you have any concerns over the learner or if the learner is injured during the placement
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Emergency arrangements
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Are there arrangements in place for emergency situations such as fire?
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First Aid
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What are your procedures if first aid is required?
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Do you have first aid supplies that can be accessed in an emergency?
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Safe and healthy working environment
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Are the premises ( structure, fabric, fixtures and fittings) safe and suitably maintained?
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Is work equipment adequate and all safety controls (guards etc) in place and are appropriately maintained?
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Personal Protective Equipment (PPE) (If applicable)
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Is the required clothing/equipment supplied (e.g. Gloves,apron)
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How will the learner be trained in the use of PPE (if applicable)
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Equality and Diversity
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Leeds City college fully comply with the Equality act 2010. Can you confirm that you comply with this legislation?
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If you have any questions or want to see a copy of our Equality and Diversity policy then please add this to the comment section.
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Welfare Facilities
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Do you have the following?<br>-Toilets <br>- Somewhere to wash hands with warm water and somewhere to heat food<br>-Rest facilities
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Health
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Are there any health risks associated with the workplace that would make it unsuitable for students with particular medical conditions? If yes, please comment:
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Are there any action points that need addressing before a young person can be placed? If yes please add details below.
Action required
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Employer Declaration
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I confirm that the information given in this questionnaire is correct. I understand my responsibility for the health, safety and welfare of the learner under the Health and Safety at Work Act 74. I will not permit them to exceed 39 hours of work, undertake work prohibited by law, or deemed to be too hazardous for the young and inexperienced. I am aware of the responsibility with regards to the protection and safeguarding of young people on work premises and agree to provide a full induction at the start of placement and provide suitable supervision at all times.
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I agree that for the purposes of audit and work related learning the information on this from may be passed to a third party. Employers name:
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In my opinion the Health and Safety for the placement is suitable for a learner. A review should be carried out on or before:
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Date:
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Approved
