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Self-Assessment Checklist
THIS INFORMATION IS INTENDED AS A GENERIC GUIDEL INE. DETAILED INDIV IDUAL ADVICE REGARDING
YOUR WORKPLACE R ISK SHOULD BE OBTAINED BEFORE PROCEEDING. AWARE365 COPYRIGHT 2012 ©
www.aware365.com.au
Aware365 can help by:
• providingobligationfreebasicinspection
(wewilldotheassessmentwithyou)
• providingcompletehealthandsafety
systemstosuityourbusiness
• Implementingandmonitoringhealth
andsafetysystemsontobusinesses
• coachingandmentoring
• customisedworkmethodstatements
Thischecklistwillhelpyourbusinesstofindoutwhatsafety issuesyouneedtoaddressor
improve,andwhenyoumayneedmoreinformation.Likeallchecklistitonlyactsasaguide
tosafety issues inyourworkplace,notasa tool thatcan identifyeverysafety issue inyour
workplace.Sodon’t relysolelyon thischecklist to identifyallyourbusiness’ssafety issues.
Forexampleyoucouldaskyourworkers,contractorsandnetworkwithothersinyourindustry
sector.RememberingthatitisyourobligationasaPCBUtoconsultwithallpeoplethatmaybe
affectedbyyouroperationsnomatterwhotheyareandwhattheirroleis.
While undertaking this self-assessment it’s important to remember the following points:
• Health and safety must just be a part of
theway you and yourworkers operate, so
alwaysconsideritasanintegralpartofactiv-
ityundertakeninyourworkplace.
• Theself-assessmentmay identifyanumber
of areas/activities where you need to take
some action. Work out the best action
that canbe takenbyconsultingwith those
employeeswhoareinvolvedintheidentified
areas/activities.
• By consulting with the relevant employees
they will take some ownership and more
readilyimplementthechangesrequired.
• ManualHandling(strainsandsprains)make
upthemajorityofreportedinjuriessomake
sureyouconsiderwhichactivitiescouldlead
tothistypeofinjury.
• Whileundertaking theself-assessment,use
the Get Active Plan (last page) to record
whatstillneedstobedone;whoisgoingto
makesure thework isdone,andwhenthe
work needs to be completed.Manage this
process and ensure some form of report
backtoemployeesofwhat’sbeenachieved.
• This self-assessmentwill only look at what
you have right now. Plan and commit to
conduct anotherone.Wherepossible have
your employees involved in assisting with
thisprocessandcomparetheoutcomes.
Self-Assessment Checklist
THIS INFORMATION IS INTENDED AS A GENERIC GUIDEL INE. DETAILED INDIV IDUAL ADVICE REGARDING
YOUR WORKPLACE R ISK SHOULD BE OBTAINED BEFORE PROCEEDING. AWARE365 COPYRIGHT 2012 ©
www.aware365.com.au
Date:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
BusinessName:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Location:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name(s):. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Position:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Instructions:Placea inoneormorebelow.Notallsectionswillapplytoyourbusinessorundertaking.
NOTE:Ifyouarenot100%surethenyoushould theNo
The Program – How safety is controlled
Yes NoNot
Applicable
ResponsibilityIsthereanidentifiedpersonwhohastheresponsibilitytodealwithhealthandsafetyissues?
Involvement and consultationIsthereaprocessofinvolvingandconsultingwithemployeesonissuesaffectingtheirhealth,safetyandwelfare?Eg changes to the work area or equipment, purchasing of new equipment, planning of new jobs, review of how jobs are done, manual handling reviews
Doeseveryoneknowhowtoreportsafetyproblemsandhazards?
Buying safeBeforebuyingequipmentormachinery,isacheckmadetomakesurethegoodsarethesafestalternativeavailableandhavetheleastmanualhandlingrisks?
Wheresecondhandequipmentormachineryispurchased,arecopiesofmaintenancerecordsandreplacementschedulesalwayssought?Arechecksmadethatallguardsareinplaceandworking?
Whenbuyingchemicals,areMaterialSafetyDataSheets(MSDSs)obtainedtocheckwhichchemicalsarethesafestalternatives?
Comment(possible solutions or relevant safety details)
Self-Assessment Checklist
THIS INFORMATION IS INTENDED AS A GENERIC GUIDEL INE. DETAILED INDIV IDUAL ADVICE REGARDING
YOUR WORKPLACE R ISK SHOULD BE OBTAINED BEFORE PROCEEDING. AWARE365 COPYRIGHT 2012 ©
www.aware365.com.au
Yes NoNot
Applicable
Beforebeingusedforthefirsttime,arenewchemicalscheckedtomakesuretheircontainersarecorrectlylabelledanddoyoumakesurethesafetyrequirementsdetailedontheMSDShavebeenputinplace?Eg safety instructions for use, personal protective clothing and equipment (PPE), storage, clean-up, and first aid.
Doyoucheckthenoiselevelsofequipmentandmachinerypurchasedorhiredtoensuretheyarelessthan85db(A)?
Beforeusingnewequipmentforthefirsttime,doyouchecktomakesureallhealthandsafetyrequirementshavebeenconsidered?
Areemployeestrainedinthesafeuseofanynewequipment,machineryorchemicals?
Labour hireIstheabilitytoworksafelyalwayscheckedbeforehiringanycontractors,labourhirestafforotherservices?
Beforecontractorsorlabourhirestaffbeginwork,arethehealthandsafetyaspectsofthejobdiscussedandplanstoworksafelyagreedto?
Looking after people (employees and contractors)Beforetheystartwork,doallemployeesandcontractorsgetinformationtokeepthemsafe?Eg site induction, emergency and first aid, who to tell about problems, information about dangers, use of personal protective clothing and equipment (PPE)
Arethereclearinstructionssothatalltaskscanbedonesafely,writtenwherepossible?
Doyouchecktomakesureworkisnotgiventopeoplewhodon’thavetherightskillsorcertificates?
Aresafetyissuesalwayslookedatbeforeanyjobstartssothatthejobisdone:
-inthesafestwaypossible
-withtherightequipment,and
-withtherightpeople?
Doyoucheckthatyouremployeesandanycontractorsareworkingsafely,eveniftheyareoff-siteortravelling?
Arenewandlessskilledemployees,contractorsorlabourhirestaffadequatelysupervisedtomakesuretheyareworkingsafely?
Doallyourteamleadersandsupervisorsknowwhattodotokeeptheirworkerssafe?Eghazards, work planning, reducing manual handling risks.
Comment(possible solutions or relevant safety details)
Self-Assessment Checklist
THIS INFORMATION IS INTENDED AS A GENERIC GUIDEL INE. DETAILED INDIV IDUAL ADVICE REGARDING
YOUR WORKPLACE R ISK SHOULD BE OBTAINED BEFORE PROCEEDING. AWARE365 COPYRIGHT 2012 ©
www.aware365.com.au
Yes NoNot
Applicable
Healthy employees
Doyouknowwhichemployeesrequirehealthchecksanddoyoumakesuretheyareprovided?Eg hearing, blood tests, breathing tests.
Haseveryonewhoneedsimmunisationshadthem?Eg Hepatitis A and B, Tetanus, Tuberculosis, Q Fever.
Doyoumakesureworkloadsdonotcausetoomuchstressandtirednessforyouremployees?
Environment – Where do you work
Clean, Tidy and comfortable
Istheworkplacecleanandtidy?
Eg there is a routine for cleaning, rubbish bin emptying and other rubbish removal; rubbish that might catch fire and oily rags are in covered metal containers; equipment and tools not being used are put away; there is no build-up of dust that may explode or catch fire.
Istheregoodstorageforequipment,tools,samples,stock,ingredientsandproduct?Eg lifting between knees and shoulders only, storage boxes easy to handle, easy access for people and equipment, shelves racking and pallets in good condition.
Haveyoucheckedtomakesurenothingcanfallontopeople?Eg from shelves or raised platforms and scaffolding,stacks can’t fall over, no-one can walk under a suspended load.
Haveyoumadesurethatemployeesarenotabletotouchhotobjectsorsurfaces?
Areyousurethatno-onecanbeaffectedbyradiation?Eg sun, X-Ray machines. etc
Areallpipeslabelled,haveenoughsupport,andhavenoleaks,dripsorcorrosion?
Haveyoumadesurethattherearen’tanysharpedgesorobjectsstickingoutthatcouldharmpeople?
Isthereenoughlightforpeopletodoeachtasksafelyandwithouteyestrainorglare?
Arepeopleprotectedfromnoisedangers?
Comment(possible solutions or relevant safety details)
Comment (Use this space to note any issues that relate to your workplace)
Self-Assessment Checklist
THIS INFORMATION IS INTENDED AS A GENERIC GUIDEL INE. DETAILED INDIV IDUAL ADVICE REGARDING
YOUR WORKPLACE R ISK SHOULD BE OBTAINED BEFORE PROCEEDING. AWARE365 COPYRIGHT 2012 ©
www.aware365.com.au
Yes NoNot
Applicable
Isthereenoughfreshincomingairandventilationtoensuregoodairquality?Isairfilteredifnecessary?Contaminants may include dust, fumes, chemicals and hazardous substances, solvents, steam, vehicle and fork lift exhaust, and asbestos fibres. Consider spray booths, fume hoods and cabinets, welding and cutting areas, photocopier rooms.
Istheworkplacekeptatacomfortableworkingtemperature?
Aretoilets,restandeatingareasofagoodstandardandawayfromareasoftheworkplacewhichcouldmakepeoplesick?
Areweatherandotherconditionstakenintoaccountbeforeanyoutdoorwork?eg the need for shelter, shade, rest, water, communication, personal protective clothing and equipment (PPE), toilet and eating facilities.
Getting Around
Arewalkwaysandstairwaysalwaysclearandsafe?Eg steps and handrails safely in place, anti-slip treads.
Isthereplentyofheadroomforpeopletomovearound?
Haveyoumadesurepeoplecan’tsliportripwhentheymovearound? Eg on oil, grease, water, leads, hoses cables.
Isiteasytogetinandoutofthebuildingsandworksite(s)safely?eg exits are clearly marked and not blocked.
Canpeoplemovesafelyaroundtrafficareasattheworkplace?eg walkways clearly marked, vehicles separate from walkways, clear vision at corners.
Arevehicledriverstrained,awareofdangers,havesafeschedules,andhaveallloadssecure,includinganythinginsidethevehicle?
How is the job completed is it safe.Proper Use
Isthecorrectequipmentalwaysusedforeachjob?
Arealltools,equipmentandmachineryappropriatelyguarded?
Haveoperatorsortoolsequipmentandmachinerybeentrained?
Arestop/startswitchesclearlymarkedandineasyreachofanoperator?
Comment (Use this space to note any issues that relate to your workplace)
Self-Assessment Checklist
THIS INFORMATION IS INTENDED AS A GENERIC GUIDEL INE. DETAILED INDIV IDUAL ADVICE REGARDING
YOUR WORKPLACE R ISK SHOULD BE OBTAINED BEFORE PROCEEDING. AWARE365 COPYRIGHT 2012 ©
www.aware365.com.au
Yes NoNot
Applicable
Hasprovisionbeenmadetosafelystorewasteoff-cutsaroundmachineryandequipment?
Isthereadequateworkspacearoundmachinery?
Aretools,equipmentandmachineryregularlymaintained(inaccordancewithmanufacturersinstructions)?
Isthereaprocesstoensurealltools,equipmentandmachineryisturnedoffpriortomaintenanceandcleaning?
Doesthisprocessensurethetools,equipmentandmachinerycannotbeturnedonbyotherstaffduringmaintenanceandcleaningprocesses?
Unsafe or faulty
Isunsafeorfaultytools,equipmentormachineryalwaysreportedimmediately?
Isunsafeorfaultytools,equipmentormachinerykeptoutofuseuntilfixed?
Arehealthandsafetyrisksconsideredbeforeanymodificationoralterationofanytools,equipmentormachinery?
Ensuring jobs are safe to completeWhat are our dangers?Havepossibledangersandhazardsbeendiscussedwithemployeesforeachjob,includingmanualhandlingtasks?
Being safeHavesafetyissueswhichwerediscussedhadactiontakentopreventanyonefrombeinginjured,includingwhenworkingoff-siteoralone?
Arethereareinstructionsorproceduresforallworkwithrisks?Eg with chemicals, equipment, electricity, lifting, etc.
Other peopleHaveyoumadesurethatyourbusinesscannotaffectthesafetyofotherpeoplewhoenteryourworkplaceorcomepastit?eg general public, customers, clients and patients, delivery people, visitors, service personnel.
Areyouremployeesprotectedfromotherswithabusiveordangerousbehaviour?Eg customer service standards and training, security, back-up personnel.
Comment (Use this space to note any issues that relate to your workplace)
Self-Assessment Checklist
THIS INFORMATION IS INTENDED AS A GENERIC GUIDEL INE. DETAILED INDIV IDUAL ADVICE REGARDING
YOUR WORKPLACE R ISK SHOULD BE OBTAINED BEFORE PROCEEDING. AWARE365 COPYRIGHT 2012 ©
www.aware365.com.au
Yes NoNot
Applicable
Manual handlingHastrainingbeenprovidedtoallnecessaryemployeeson
-howtorecognisehazardousmanualhandling
-howtodoriskassessmentsand
-howtofindeffectivesolutions?
Haveyoulistedalltasksinvolvinghazardousmanualhandlinganddecidedonrealistictimeframestocarryoutariskassessment?
Hastheriskassessmentsyouhaveundertakentakenintoaccountthefactorsofposture,movement,forces,duration,frequencyandenvironmentalfactors?
Haveyouidentifiedsolutionstoyourareasofhazardousmanualhandlingbyconsideringimprovementsintheworkarea,thesystemofwork,theobject/sbeinghandledandtheequipmenttodothetask?
Haveyouconsideredwhethertherearemechanicalaidswhichcouldbeintroducedtoassisttheprocessandmakeworkeasierandsafer?
Ifyouhavenotbeenabletoadoptthelasttwomeasurestothehazardousmanualhandlingproblem,haveyouprovidedinformation,trainingandinstructiontoensurethesafetyofyouremployees?
Whenyouintroduceanewsolutiontomanualhandlingdoyoucheckthatthenewsolutiondoesnotcreateanotherproblem?
ElectricityAreyousuretherearenobrokenelectricalplugs,socketsorswitches?
Areyousuretherearenodamagedelectricalleads?
Haveyoumadesurethattherearenoelectricalleadsonfloorsormultipleplugadaptorsused?
Haveelectricalleadsandpowerboardsbeencheckedandtaggedassafe?
Isthelocationofpowerlinesandcablescheckedbeforedigging,drilling,useofcranesorothersimilarwork?Eg overhead, underground, underfloor, other side of walls.
Doyouensureportableladdersareneverusednearelectricalequipmentorpowerlines,unlessmarkedasnon-conductive?
Comment (Use this space to note any issues that relate to your workplace)
Self-Assessment Checklist
THIS INFORMATION IS INTENDED AS A GENERIC GUIDEL INE. DETAILED INDIV IDUAL ADVICE REGARDING
YOUR WORKPLACE R ISK SHOULD BE OBTAINED BEFORE PROCEEDING. AWARE365 COPYRIGHT 2012 ©
www.aware365.com.au
Yes NoNot
Applicable
Chemicals and other dangerous substances – powders, liquids, and gases.Isthereanuptodatelistofallchemicalsused?Eg cleaning products, paints, solvents, degreasers, petrol, inks, toner, oils, plastics, acids, alkalis, pesticides.
DoyouhaveinformationaboutchemicalsyouuseieaMaterialSafetyDataSheet(MSDS),whichcanbeobtainedfreefromsuppliers?
DoemployeeshaveaccesstoanMSDSforchemicalstheyuseorareexposedto?
Areallchemicals,medicationsandcontainersclearlylabelled?
Haveallemployeeshadtrainingandinstructiononthesafeuse,handling,transportandstorageofallchemicalstheyuse?Eg acids, caustics, epoxies, phenols, solvents.
Arewashingfacilitiesclosetoareaswherechemicalsareused,incaseofemergencies?
Istheregoodairflowandremovaloffumesfromanyareawherechemicalsareused?Eg exhaust canopy used.
Areallchemicals,medicationsandwastesstoredcorrectly?Eg specific storage rooms and cupboards, separation distances, not with other substances that may react, solvents in fire-resistant containers, no smoking or other ignition sources nearby, dip tanks cleaned and maintained.
Aregascylinderspreventedfromfallingover,awayfromheatandignitionsources,andnotcarriedinvehiclecabinsunlessinaventedcompartment?
Areemptygascylindersstoreduprightinanareaclearlymarked‘emptycylinders’?
Isallchemical,medicationorwastedisposedofcorrectly?
Risk of InfectionArepossibleinfectionsprevented
-fromanimals?
-fromhumans,bloodandbodyfluids?
-fromwasteandrubbish?
Comment (Use this space to note any issues that relate to your workplace)
Self-Assessment Checklist
THIS INFORMATION IS INTENDED AS A GENERIC GUIDEL INE. DETAILED INDIV IDUAL ADVICE REGARDING
YOUR WORKPLACE R ISK SHOULD BE OBTAINED BEFORE PROCEEDING. AWARE365 COPYRIGHT 2012 ©
www.aware365.com.au
Yes NoNot
Applicable
SprayingDoallinsidesprayingareasuseboothswhichmeetAustralianStandard(AS4114:1)?
Doonlytrainedpeopledosprayingwork?
Aresignsdisplayedwhichalwayswarnothersofoutdoorsprayingwork?Eg herbicides, pesticides.
Istherightpersonalprotectiveclothingandequipment(PPE)alwaysused?Eg gloves, footwear, coveralls, respirators and masks.
Welding and cuttingIsweldingandcuttingonlydonebyauthorisedandtrainedpeople?
Isfireandexplosionprevented?Eg electrical power shut off when not in use, use of flash shields, fire watcher, protection of flooring that could burn or catch fire, any substances removed completely that could explode, catch fire or produce toxic vapours.
Areweldingandcuttingequipment,cables,andcompressedgascylinderscheckedfordefects,rustandleakage?
Working in or entering confined spacesHaveallconfinedspacesbeenidentifiedasperthedefinitionintheRegulations
Aretherestrictproceduresandpermitsforenteringorworkinginaconfinedspace?Eg no corrosive or dangerous substances, supply lines cut-off, moving parts locked out, natural or mechanical ventilation, air quality checked, enough lighting, standby person, emergency and rescue procedures and equipment.
Doonlythosetrainedandwiththerightequipmententeraconfinedspace?
Work at heightsHavealltasksneededtobeundertakenatheightbeenidentified?Eg access to areas for repair, maintenance, cleaning or inspection, operation and maintenance of equipment.
HaveappropriatefallpreventionmethodsbeenputinplaceEg guardrails, scaffolds or other temporary work platforms, harness systems.
Comment (Use this space to note any issues that relate to your workplace)
Self-Assessment Checklist
THIS INFORMATION IS INTENDED AS A GENERIC GUIDEL INE. DETAILED INDIV IDUAL ADVICE REGARDING
YOUR WORKPLACE R ISK SHOULD BE OBTAINED BEFORE PROCEEDING. AWARE365 COPYRIGHT 2012 ©
www.aware365.com.au
Yes NoNot
Applicable
What happens If things go wrongEmergency proceduresArethereprocedurestocoverpossibleemergenciesandcoveremployees,anyonewithmobilitydifficulties,visitors,clients,patients,childrenandcustomers?Egfire,explosion,chemicalspill,flood,medicalemergency,machineryaccidents,motorvehicleaccidents,robberyandhold-up.
Havethoseinchargeorwithspecialdutiesduringemergenciesbeentrained?
Areexitandassemblypointseasytogetto?
Areevacuationplansondisplayinaprominentarea?
Doexitdoorsopeneasilyfrominside,includingcoldstoreroomdoors?
Haveallemployeespracticedemergencyprocedures?
Isallemergencyequipmentinplaceandworking?Egsmokeorheatdetectors,sprinklersystems,fireextinguishers,duressandotheralarms,emergencylighting,firedoors,eyewashandshowers.
DoyouunderstandtherequirementtonotifyWorkplaceStandardsTasmaniaimmediatelyintheeventofaseriousinjuryorincident?(WorkplaceStandardsTasmaniaHelpline1300366322)
First aid
Havepossibletypesofinjuriesbeenconsidered?
Haveyouassessedwhetheryouneedaqualifiedfirstaider?
Ifyouneedaqualifiedfirstaider,dotheyhaveandmaintaintheirqualifications?
Doyoukeeprecordsofanyfirstaidprovided?
Injury/illness/incident reportingIsaregisterofinjuriesintheformatrequiredbytheAccidentCompensationAct1985keptandavailabletoallemployees?Ie name of injured worker, worker’s age, worker’s marital status, worker’s address, time and date of occurrence of injury cause of injury, nature of injury, date of entry.
Comment (Use this space to note any issues that relate to your workplace)
Self-Assessment Checklist
THIS INFORMATION IS INTENDED AS A GENERIC GUIDEL INE. DETAILED INDIV IDUAL ADVICE REGARDING
YOUR WORKPLACE R ISK SHOULD BE OBTAINED BEFORE PROCEEDING. AWARE365 COPYRIGHT 2012 ©
www.aware365.com.au
Yes NoNot
Applicable
Isinformationintheregisterofinjurieskeptconfidential?
Areworkersgivenawrittenacknowledgementtoletthemknowthebusinesshasgottheirinjury/illnessreportandwhenyoureceivetheirworkers’compensationclaim?
Doyouhaveyour“Ifyouareinjured”posterdisplayedinanareaavailabletoallstaff?
Whensomethinggoeswrong,arethecauseslookedintoandactionstakentostopanythingsimilarfromhappeningagain,evenafterreportsofpain,strainorsprain?
Rehabilitation and return to work
Isthereacurrentworkercompensationpolicy?
Doallworkersknowabouttheworkers’compensationandrehabilitationprocessinthisbusiness?
DoesthebusinessknowwhentheymustappointaReturntoWorkCoordinatoranddosowhenappropriate?
IsthereaReturntoWorkplanforallworkersreceivingworker’scompensation
Areclaimsforworkers’compensationlodgedwithyourAgentwithinsettimeframes?
Isthereachoiceofapprovedrehabilitationprovidersforuseifneeded?
Comment (Use this space to note any issues that relate to your workplace)
Self-Assessment Checklist
THIS INFORMATION IS INTENDED AS A GENERIC GUIDEL INE. DETAILED INDIV IDUAL ADVICE REGARDING
YOUR WORKPLACE R ISK SHOULD BE OBTAINED BEFORE PROCEEDING. AWARE365 COPYRIGHT 2012 ©
www.aware365.com.au
Get Active PlanIdentified Problem Action required Person
responsibleDate of action to be
completed
Review date & comment
Highpriority
Mediumpriority
Self-Assessment Checklist
THIS INFORMATION IS INTENDED AS A GENERIC GUIDEL INE. DETAILED INDIV IDUAL ADVICE REGARDING
YOUR WORKPLACE R ISK SHOULD BE OBTAINED BEFORE PROCEEDING. AWARE365 COPYRIGHT 2012 ©
www.aware365.com.au
Get Active PlanIdentified Problem Action required Person
responsibleDate of action to be
completed
Review date & comment
Lowpriority