WPA - Workplace Assessment - Gas

Gas Workplace assessment

• Conducted on

  Date

• Conducted by

• Licence No.

• Gas Engineer

• Licence No.

• Job No.

• Location of work

• Job Description

On site behavior

• Has the engineer Contacted the PIC, introduced himself and explained why he's there?

  Yes

  No

  N/A

• Has the engineer signed into the site log?

  Yes

  No

  N/A

• Has the engineer checked the site hazard list?

  Yes

  No

  N/A

• Which hazards are in the work area?

  Select Asbestos Working at height Confined Space Yard work Slips trips & falls Working close to others Hot work Pressure None

  • Asbestos
  • Working at height
  • Confined Space
  • Yard work
  • Slips trips & falls
  • Working close to others
  • Hot work
  • Pressure
  • None

• Which SSOW will be consulted?

  Select Asbestos Working at height Confined Space Yard work Slips trips & falls Working close to others Hot work Pressure None

  • Asbestos
  • Working at height
  • Confined Space
  • Yard work
  • Slips trips & falls
  • Working close to others
  • Hot work
  • Pressure
  • None

• Is the engineers PPE in good order and within it's replacement date if a date is given (e.g. Helmets)

  Yes

  No

  N/A

• Add an action to make up deficiency, send to engineer and manager, re-check in 30 days

• Are Safe Systems of work required for the work being assessed?

  No

  Yes

• What Safe Systems of work will be used to maintain safety during the work assessed?

• Are test instruments calibrated and in good condition?

  Yes

  No

  N/A

• Create an action for re-calibration / replacement / repair of test equipment and re check in 30 days

• Are sufficient tools and consumables available for the job at hand?

  Yes

  No

  N/A

• Add an action to make up deficiency, send to engineer and manager, re-check in 30 days

• Does the engineer carry the means to safely physically disconnect the appliance or system from it's gas supply in the event of discovering an Immediately Dangerous condition?

  Yes

  No

  N/A

• Add an action to make up deficiency, send to engineer and manager, re-check in 30 days

• Does the engineer have available to him, the means to clean a boiler combustion chamber? e.g. Brushes, Vacuum cleaner?

  Yes

  No

  N/A

• Add an action to make up deficiency, send to engineer and manager, re-check in 30 days

• Does the engineer carry up to date "Do Not Use" safety labels and hard copy Warning Notices?

  Yes

  No

  N/A

• Add an action to make up deficiency, send to engineer and manager, re-check in 30 days

• Can the engineer carry out a basic tightness test to an acceptable standard?

  Yes

  No

  N/A

• Recommendation ?

• Can the engineer calculate the required ventilation for an appliance at the site and determine whether it is compliant?

  Yes

  No

  N/A

• Recommendation ?

• Can the engineer determine whether to record Gas Rate and/or burner pressure and determine that performance is within Manufacturers specification?

  Yes

  No

  N/A

• Recommendation ?

• Can the engineer test flue performance satisfactorily?

  Yes

  No

  N/A

• Recommendation ?

• Can the engineer perform a flue gas analysis satisfactorily?

  Yes

  No

  N/A

• Recommendation ?

• Can the engineer perform a flue gas analysis and carry out any air testing required in a competent manner?

  Yes

  No

  N/A

• Recommendation ?

• Can the engineer determine that the appliance safety controls are functioning correctly?

  Yes

  No

  N/A

• Recommendation ?

• Has the engineer got a copy of IGEM/G/11 the industry unsafe situations procedure?

  Yes

  No

  N/A

• 1 - Provide a copy by Email or USB stick or 2 - Link to the company intranet and download to their MDU

• Can the engineer recognize deal with and Immediately Dangerous situation appropriately?

  Yes

  No

  N/A

• Add an action to support the engineer in becoming competent at this within 30 days.

• If deficiency is severe, consider escalation to a higher level for action.

• Can the engineer recognize deal with and At Risk situation appropriately?

  Yes

  No

  N/A

• Add an action to support the engineer in becoming competent at this within 30 days.

• If deficiency is severe, consider escalation to a higher level for action.

• Can the engineer recognize deal with and RIDDOR situation appropriately?

  Yes

  No

  N/A

• Add an action to support the engineer in becoming competent at this within 30 days.
  Reminder that there is a requirement that harm is LIKELY to arise to raise a RIDDOR.

• Can the engineer decide and act upon situations were defects exist that are NOT safety concerns and deal with them appropriately?

  Yes

  No

  N/A

• Add an action to make up deficiency, send to engineer and manager, re-check in 30 days

• Does the engineer know how to report incidents and near misses to the Helpdesk / CAB Helpdesk?

  Yes

  No

  N/A

• Add an action to make up deficiency, send to manager, re-check in 30 days

• Pre populate these questions to give yourself time during the assessment.
  
  Ask the engineer questions, before during and after the assessment, as necessary to gain an understanding of his or her level of underpinning knowledge of the work being carried out.
  
  Looking the answer up in a text or reference book or online and getting it RIGHT counts as a YES

• Q1

• Correctly answered?

  Yes

  No

• Re-phrase the question?, follow up or come back to it later. If unable to secure a correct response then
  
  Add an action to the engineer to provide an answer within 7 days.

• Q1

• Correctly answered?

  Yes

  No

• Re-phrase the question?, follow up or come back to it later. If unable to secure a correct response then
  
  Add an action to the engineer to provide an answer within 7 days.

• Q1

• Correctly answered?

  Yes

  No

• Re-phrase the question?, follow up or come back to it later. If unable to secure a correct response then
  
  Add an action to the engineer to provide an answer within 7 days.

• Q1

• Correctly answered?

  Yes

  No

• Re-phrase the question?, follow up or come back to it later. If unable to secure a correct response then
  
  Add an action to the engineer to provide an answer within 7 days.

• Q1

• Correctly answered?

  Yes

  No

• Re-phrase the question?, follow up or come back to it later. If unable to secure a correct response then
  
  Add an action to the engineer to provide an answer within 7 days.

• Are there any Limitations or Exclusions relevant to this assessment?

  No

  Yes

• Details of any exclusions or limitations relevant to this assessment

• Are there any gas safety issues with this appliance/system that have required an Incident/Near miss/Good practice report to be raised?

  Good Practice

  Near miss

  At Risk

  Immediately Dangerous

  N/A

• Please give details.

• In the light of the above this engineer

  Can be left to carry out this type of work with minimal supervision for a period of no longer than 12 months

  Can be left to carry out this type of work with minimal supervision for a period of no longer than 6 months

  Requires some support to become competent in this type of work

  Requires some retraining in this type of work

  Cannot be left to carry out gas work unsupervised

• Inform line manager, and request engineer is removed from work planning in respect of gas work.

• Has the engiineer been prevented from carrying out work on gas alliances and systems?

  Yes

  No

  N/A

• Detail reasons why the engineer has not been prevented from carrying out gas work

• Recommended date of next assessment

  Date

• I acknowledge and accept the findings above

  Sign

• Supervisors signature

  Sign