HAZARD CHECKLIST for (Workplace) ………………………… Date ……. /……/………….
Electrical hazards Yes/ Report What action is
No to needed?
Any exposed leads
Electrical equipment checked regularly and
tagged
Any double adaptors
Manual handling
Limits to weight to be lifted are signed
Equipment available for heavy lifting
Heavy objects labelled with a warning
First aid
First Aid kit available at all times
First Aid kit stocked adequately
First Aid Kit checked regularly
First Aid contact person clearly identified
Passageways
Passageways are clear, nothing to trip over
Passageways are wide enough for everyone
Safe surface for walking on
Steps not too steep
Handrails if needed
Access ramps available where needed
Work Environment
Good air quality
Air is free of fumes
Comfortable working temperature
Noise levels are comfortable for working
Enough lighting
Air conditioning working and regularly checked
Furniture allows for normal body positions when
seated or standing
Work Environment
Computers at correct height
No sharp edges
No low overhead projections
No items stored in non–storage areas
Electrical hazards Yes/ Report What action is
No to needed?
e.g., on top of cupboards
Washing and eating areas clean and free of
rubbish
Security and Emergency
Emergency exits clearly marked
Exits accessible and unlocked
Exit doors opening outward
Emergency procedures clearly displayed
Emergency contact numbers clearly displayed
Emergency procedures known by all workers
After hours’ security procedures adequate
Fire doors closed at all times
Fire extinguishers available
Fire extinguishers checked regularly
Risk Control Action Sheet
Contribute to the development, implementation and evaluation of risk control
Complete the Action Plan Below. You may make any assumptions about the date and the period of time
required to close out the tasks assigned.
No Item ACTIONS PERSON TARGET COMPLETED
RESPONSIBLE DATE
1
10
11
12
13
14
Assessor Feedback
Assessor decision (circle) Satisfactory Not satisfactory
Signed Assessor
Date
Toolbox safety meetings/pre-start talks
All Toolbox safety meetings/pre-start talks undertaken on behalf of are recorded
on this form and signed by participants.
All corrective actions noted on this form are implemented and signed by the nominate
person. It is the responsibilities of the Work Supervisor to ensure that all corrective actions
are completed and reviewed for effectiveness.
Toolbox safety meetings/pre-start talks
Business name:
Subject of talk:
Presented by:
Duration: Date:
Person present
Print Name: Signature: Print Name: Signature
Points Raised/ Comments:
Corrective Action Action by Action complete
Sign off Date