ohs implementation calendar web viewensure the contents of the whs induction checklist have been...

WHS ACTIVITIES CALENDAR 2016/17

Activity

Frequency

July August September October November December January February March April May June

First Aid Kit Checklist Quarterly Initial Implementation Plan Annually

Update or review Noticeboard and Forms 6 Monthly

Workplace Inspections Quarterly Consultation: Safety / Team Meetings Quarterly

Review Workplace Risk Register Quarterly

Review Emergency Management Procedure 6 Monthly

Emergency Evac Drill Annually Chemical/Hazardous Substance Register Annually

Contractor Induction Annually or as required

Safety Training Annually or as required

Workstation Ergonomic Risk Assessment

Annually or as required

Workplace Traffic Hazard Management


Managing Plant and Equipment


Maintenance Check of Plant and Equipment 6 monthly

Document Management Annually or as advised

Assembled Product Review Biannually

Internal Self Evaluation Annually

– Left hand box Activity planned – Right hand box Activity completed

JULY 2016

INITIAL IMPLEMENTATION PLAN

ACTION WHO DUE COMPLETED REVIEWED

Confirm the location’s Safety Representative to Dennis Bastas (HR & WHS)

Place Freedom’s WHS Policy, Consultation Statement and RTW Program (* (NB all policies can be placed on top of each other if space is an issue)

Your agreed WHS Activities Calendar for July 16 – June 17.

Applicable WorkCover/WorkSafe poster (NSW,VIC,ACT)

Completed Emergency Summary Sheet and Evacuation Plan, Diagram or Map

Create a spot for your Record of WHS Discussion on your WHS Noticeboard, or if you have a Committee then WHS Committee Meeting Agenda and Minutes

Any other relevant memo’s or documents such as a Dennis’ Monthly Activities Calendar Reminder.

Ensure the contents of the WHS Induction Checklist have been completed by all new employees.

Ensure you are familiar with the Emergency Management Procedure and First Aid Administration Procedure. Ensure you have adequate First Aiders, place a copy of the First Aid Contents Checklist near to the first aid cabinet – allocate someone to be responsible for this.Ensure your employees know about your emergency plans and hazard and incident reporting procedures – document this.Refer to the Self Evaluation Record Form for more detailed requirements of the system – decide who will conduct this review using the Self Evaluation form to prepare for your audit.

EMERGENCY MANAGEMENT and EVACUATION COORDINATION

NOTE: It is recommended you download this word document and save on your drive. Use the digital copy as the main document and update as required.

PurposeThe purpose of this procedure is to establish, implement and maintain generic procedures for the controlled evacuation of premises arising from foreseeable emergency situations that may pose a threat to the health and safety of employees and non employees. Specific requirements of this procedure will need to be adapted for local requirements.

ScopeThis procedure applies to all operations and staff of Steinhoff Asia Pacific.

Emergencies that could impact on Steinhoff Asia Pacific operations include: fire or explosion robbery or violent incident phone threat electrical failure medical emergency hazardous materials air conditioning contamination civil disorder structural fault, and natural disaster (e.g. earthquakes, flooding).

The workplace/facility that this procedure applies to is:

Name of building/workplace:Address:Telephone number:Hours of operation:Name of building agent:Telephone number of agent:

Fire Safety and Emergency Features

The following fire safety and emergency features are present in this building:

Review

This procedure was last reviewed on:

A review of this procedure must take place at intervals of not more than 5 years.

References Relevant Work Health and Safety Acts & Regulations. Australian Standard 3745-2010 Planning for emergencies in facilities Building Fire Safety Regulation 2008 (Qld)

Responsibilities As part of the emergency procedures, an emergency team has been established to carry out specific tasks whilst the evacuation is taking place. These positions (with names) and their responsibilities include:

Emergency Planning Committee (EPC)

(insert name here) (insert name here)The EPC shall consist of not less than two people who shall be representative of the stakeholders in a facility, one of whom shall be management.The EPC is responsible for: identifying events that could reasonably produce emergency situations developing an emergency plan establishing an Emergency Control Organisation (ECO) to operate in accordance with the emergency plan.

Emergency Control Organisation (ECO)

The primary role of the ECO is to give top priority to the safety of the occupants and visitors of the facility during an emergency. Life safety shall take precedence over asset protection during an emergency. The number of ECO members shall be determined in accordance with the size of the facility, the number of occupants and visitors, the occupants warning system in place and other fire safety features of the facility. The members of the ECO consist of:

Chief Warden / Evacuation Coordinator

(insert name here) The chief warden is responsible for: staff training assessment of emergency deciding to evacuate notifying emergency services, and coordination of emergency services.

The chief warden shall be identified by a white helmet/cap with the words ‘Chief Warden’ labelled. A cheat sheet has been created to be used as a guide in the event of an emergency. It has been designed to be prinited and laminated and located with the wardens hat so in the event of an emergency, the chief has a card which provides guidance on what to do next.

Note: The Chief Warden’s instructions during emergencies shall override normal management structure.

Deputy Chief Warden

(insert name here)The deputy chief warden is responsible for: staff training fire prevention notifying the emergency services notifying the chief warden and management deciding to evacuate, and coordination of personnel for evacuation duties.

The deputy chief warden shall be identified by a white helmet/cap with the words ‘Deputy Chief Warden’ labelled. A cheat sheet has been created to be used as a guide in the event of an emergency. It has been designed to be prinited and laminated and located with the wardens hat so in the event of an emergency, the chief has a card which provides guidance on what to do next.

Area Wardens / Wardens

(insert name here)(insert name here)(insert name here)

Area wardens are responsible for: on becoming aware of an emergency implement the emergency procedure notifying the chief warden of the location and extent of the emergency helping to combat the emergency if trained and if safe to do so, and assisting the deputy chief warden in the above duties.

Area wardens shall be identified by a yellow helmet/cap with the words ‘Area Warden’ labelled. Wardens shall be identified by a red helmet/cap with the words ‘Warden’ labelled. Their area of control shall also be determined as a part of the emergency procedure. A cheat sheet has been created to be used as a guide in the event of an emergency. It has been designed to be prinited and laminated and located with the wardens hat so in the event of an emergency, the warden has a card which provides guidance on what to do next.

Note: Not all locations will require both Area Wardens and Wardens. Smaller locations may manage with Wardens only.

Fire Safety Advisor (Queensland only)

Fire Safety Advisor: (insert name here)Date of training:Work Address:Work Telephone:

In Queensland, the appointment of a Fire Safety Advisor is a legislative requirement under the Building Fire Safety Regulation 2008. The occupier of a high occupancy building or where 30 or more workers are normally employed must appoint a person who is to be trained as the fire safety advisor for the building. If the occupier is the occupier of 2 or more high occupancy buildings, the occupier may appoint the same person as the fire safety advisor for 2 or more of the buildings. The fire safety advisor must be trained in a course in accordance with the Building Fire Safety Regulation 2008.

Location Manager

(insert name here)Location managers are responsible for: ensuring an emergency team is established reviewing this procedure as required co-ordinating with the emergency team to conduct drill evacuations annually, and undertaking the role of deputy chief warden if needed with the emergency team to ensure back up of the chief

warden.

Receptionist/Administration

(insert name here)The receptionist is responsible for: notifying the chief warden of the visitors / contractors signed in, and giving the chief warden a copy of the hazardous substance register in the event of an emergency evacuation.

First Aid personnel

(insert name here)(insert name here)

The First Aid personnel are responsible for:

undertaking their first aid duties as required during an emergency response or evacuation.

Note: Once an emergency is declared, the powers of all wardens (including the chief warden and deputy wardens) shall override all normal non emergency management procedures. Area wardens shall have the authority to marshal all staff and any visitors to their area. The purpose of these powers is to ensure that during an emergency situation, life safety takes precedent over asset protection and production matters. The procedures require consideration to be given to ensure the protection of wardens, the person or persons refusing to comply, and other personnel in the area when a refusal situation arises.

Procedure Emergency Summary SheetLocation managers are responsible for completing the Emergency Summary Sheet and displaying it permanently in relevant work areas such as the MySafety Noticeboard, staff room and administration area.

Emergency Evacuation DiagramLocation managers are responsible for completing a site specific emergency evacuation diagram for the workplace and displaying it permanently in locations where occupants and visitors are able to view the diagrams, such as the MySafety Noticeboard. The diagram must have the title ‘EVACUATION DIAGRAM’, show the designated emergency exits, the fire fighting equipment, the fire indicator panel and intercommunication system (where installed), any manually operated fire alarms, first aid facilities, the designated assembly area either stated in words or pictorially represented, the validity date of the diagram, and a legend which shall reflect the symbols used. It is also required to show the words “YOU ARE HERE” with an arrow pointing to a red dot on the diagram where the diagram is displayed, and show the exit routes from the place where that diagram is displayed to the nearest exit of the building. The diagram must have the correct orientation with regard to the direction of egress. Assembly areas shall, so far as is reasonably practicable, be sufficiently distant from the emergency for the protection of evacuees.

Refer to Appendix A for an example of an Evacuation Diagram.

Note: A qualified fire safety services and training company may be consulted by the location manager to assist with the development of the emergency evacuation diagram.

Emergency and Fire Awareness TrainingLocation managers are to: ensure emergency training is included in all employee inductions (refer to the WHS Induction Checklist and the

Emergency and Fire Awareness Induction Checklist) ensure all workplace occupants undertake a skills retention activity annually to enable them to act in accordance

with an emergency. This can be facilitated via a team meeting. ensure all wardens are trained in their responsibilities by competent persons (i.e.: external fire services training

provider). This may include first attack and fire extinguisher training

Emergency and Fire Awareness training summaryTraining FrequencyAll employees WHS Induction Checklist Commencement of employmentAll employees Emergency and Fire Awareness Induction Checklist Commencement of employmentGeneral occupant emergency response procedures training AnnuallyECO (Warden and Fire Extinguisher) training 2 year intervalsECO skills retention activity 6 monthly intervalsFire Safety Advisor (Queensland only) Within 1 month of commencement

Warden training is to account for as a minimum: the layout of the area or floor for which they are responsible. They should know the existence of, and the positions

of, rooms leading off blind passages, doors leading to dead ends and other concealed areas in which persons could be located

evacuation routes and safe places the operation of, and procedures for use of, the communications equipment and alarm-initiating devices

the number, location and means of assistance for persons with disabilities on their floor or in their area. In such as case a Personal Emergency Evacuation Plan (PEEP) may be required.

the operation of all fire-detection and suppression systems any special procedures that may exist to protect strategically significant items located in their area any dangerous goods / hazardous substances that may need special attention or isolation, and the operation of portable fire extinguishers, fire hose reels and fire blankets.

Emergency Response Exercises PlanningLocation managers shall schedule emergency response exercises to be held at least annually. These exercises shall be documented on the WHS Activity Calendar.

In addition to the emergency response exercise, the emergency team shall meet at 6 monthly intervals to review the Emergency Procedure, participate in skills retention and revise their responsibilities.

Conducting Emergency Response ExercisesEmergency response exercises shall be conducted in accordance with the schedule in the WHS Activity Calendar. The chief warden shall communicate the following to all area wardens: the identity of the chief warden, the deputy chief warden and each warden alarm system the method of reporting emergencies actions they are to take in response to the alarm signals location of the evacuation meeting point for their area the evacuation route they are to take, and what is required at the completion of the exercise.

The chief warden shall post a notice on the staff notice board with the above details. This shall be done at least one week prior to the exercise.

Area wardens shall then communicate these details within their area of control. This shall also be done at least one week prior to the exercise.

An observer shall be appointed by the chief warden to assess the evacuation exercise. The observer is required to use the Emergency Evacuation Exercise Observers’ Checklist. This form is to be submitted to the chief fire warden at the completion of the exercise. Records of non conformances and the associated corrective action shall be maintained on this form. Location managers are responsible for verifying that all corrective actions are effective.

The exercise shall be conducted in accordance with this procedure.

Emergency EvacuationAll employees are responsible for notifying their warden or their supervisor of emergency scenarios (supervisors will then be responsible for notifying their warden).

Once an emergency scenario has been reported to a warden, the warden is to determine whether emergency procedures are to be activated.

If emergency procedures are to be activated, the warden is to sound the ‘Alert’ signal and notify the chief warden.

Once the ‘Alert’ signal has been activated, wardens and deputy chief warden are to attend their meeting post and await further instruction from the chief warden.

All people on site are to prepare to evacuate, but are to remain in their work area at this time.

The chief warden is to decide whether or not to evacuate.

If the decision is to cancel the evacuation, the ‘Alert’ signal is to be cancelled and a response given to all persons by the chief warden as follows:

“This is the chief warden. An incident was identified earlier and an investigation conducted. You are not required to evacuate. Please return to work and a debrief will be conducted with all wardens. Can all wardens please proceed to the location manager’s office where a debrief will be conducted”.

If the decision to evacuate is executed, the ‘Evacuate’ signal is to be activated and the Emergency Services “000” contacted.

NOTE: in some cases, there may be not be a two-stage ‘Alert/Evacuate’ alarm system but only a single stage ‘Evacuate’ alarm. In this case, the full evacuation is to begin immediately. If there is no emergency alarm at all, alternative procedures must be used to alert occupants of the emergency.

Once the ‘Evacuate’ signal is activated, all persons are required to evacuate to the emergency assembly area.

The warden is to conduct a sweep of their area with the view to: directing all persons to the relevant meeting point identifying any hazards, and assisting injured / disabled persons.

Once the sweep has been conducted, the warden is to proceed to the evacuation meeting point and report back to the chief warden.

At the evacuation assembly area, the wardens conduct a roll call for all persons for their area. They are to ask occupants if they notice anyone who was present prior to the evacuation is now missing. This includes contractors and visitors who have signed in. Any unaccounted for persons are to be reported to the chief warden who in turn reports to the Emergency Services with their likely whereabouts.

Occupants and visitors are not to re-enter the site until allowed by the chief warden.

If the sweep identifies any injured / disabled persons, the warden is to assist those persons to a safe zone (i.e. stair well) and notify the chief warden who in turn notifies the emergency services with location and other details. The warden is to remain with the injured / disabled person until assistance arrives.Any persons requiring first aid will have access to first aid personnel at their evacuation assembly area.

If it is safe to do so, the chief warden will instruct all persons to return to their work area.

Emergency Evacuation Debrief (for actual and drill evacuations)The chief warden is to conduct a documented debrief with all wardens covering the following: the evacuation results as documented on the Emergency Evacuation Exercise Observers’ Checklist the nature of the incident the adequacy of communications the time taken to evacuate the execution of instructions / procedures the adequacy of procedures interaction with external agencies injuries, and any other issues.

Medical EmergencyLocation managers and / or first aiders will call for qualified assistance in a medical emergency.

Employees will co-operate as required with the first aid officers and / or their supervisor.

Location managers and / or first aid officers will advise the ambulance or medical services of: number of people involved suspected condition (i.e.: heart attack or physical injury), and

location of where employees / people are.

The injured persons will be assisted to the limit of emergency personnel resources, reassured and made comfortable until qualified assistance arrives. Where injured persons are conscious, and they advise no to assistance, do not proceed.

Robbery or Violent IncidentIn the event of an armed hold up, all employees will be required to adhere to the following procedures at all times: follow Instructions - do exactly what the offender says stay calm and quiet avoid eye contact do not make a sudden movement remain inside the workplace - do not chase the offender show your hands - if you have to move, keep your hands where the offender can see them and tell them what you

are going to do do not attack the offender, and make mental notes - note as much information about the offender as possible, if it is safe to do so. Look at things

like height, hair colour, eyes, physical condition and tattoos/special marks.

Report the incident immediately to your supervisor, only when it is safe to do so.

Location managers have a responsibility to: once safe, call the police seal off the area as vital evidence may be destroyed if this is not done ask witnesses to remain, in order for the police to conduct investigations and have all witnesses write down their

account of the event, before they talk to others about the event have accredited first aid officers treat injured or traumatised people assist in providing post-traumatic stress counselling ensure employees have understood what has happened and update them if necessary. Allow them to make contact

with family members if they wish to do so, and notify the local regulatory authority (i.e.: WorkCover) immediately. Phone ThreatsIn the event of a phone threat the recipient of the call is to attempt to keep the caller on the line for as long as possible by asking the questions listed on the Phone Threat Checklist.

A copy of this form must be kept near the reception telephone.

Meanwhile get the attention of a manager, or someone who can alert the manager that a phone threat is taking place. You can do this by displaying the reverse of the Phone Threat Checklist.

The recipient of the call will need to mentally keep him or herself calm, so that they can focus on getting as much information as possible about the phone threat.

Location managers have a responsibility to: alert the police ensure a search of the premises is conducted, using any information supplied by the caller as a guide, and if any unknown package is found, the manager is to conduct an evacuation of the premises as per the evacuation

procedures.

Electrical failure

In the event of an electrical failure the ECO should undertake the following: chief warden and wardens are to investigate the premises to look for potential sources of power failure (portable

torches will be useful at this time)

chief warden is to ask occupants to remain calm and at workstations or in common areas (preferably with natural light)

ask visitors to exit the building or relocate to a common supervised area. Do not allow visitors to continue with their business, or be allowed to enter the premises during an electrical failure, unless they are seeking refuge.

if the failure is not localised, the chief warden is to contact the electricity provider for the site make announcements on the situation every 10 minutes cease normal operations and processes and focus on people safety and protecting the business and assets. If there is

no need to leave the premises immediately (no physical threat) stay in place until the chief warden has authorised an evacuation to the assembly area or other stop work arrangements. If the premises are equipped with emergency lighting you can remain in the premises. Occupants should not remain in the building after the emergency lights go out.

Hazardous materialsThis may include biological, chemical or radiological substances. Avoid handling the substance – quarantine and confine it. Advise the chief warden Notify the emergency services If the substance has been touched, ensure those people are separated from others and if available washed or

showered. Clothes should be quarantined for analysis. Keep area clear until arrival of emergency services The air conditioning system should be shut down immediately.

Air conditioning contaminationIn the event of air conditioning contamination the Chief Warden is to be contacted, who shall shut down the air conditioning systems immediately, even if the contamination is minimal. Call the Police or Fire Services and request assistance. If the contamination is hazardous or the air conditioning units cannot be over-ridden, it may be necessary to evacuate to the assembly area or another safe area. Be mindful that the cause of the contamination may be outside. Adhere to the Emergency Services instructions.

Civil DisorderCivil disturbances such as protests and forced entry can affect buildings for a variety of reasons includingaffairs of a political, economical and corporate nature. The chief warden should take the following action: notify the Police and request assistance (and Security company if present) alert members of the ECO and management inform facility occupants and visitors of restrictions to be implemented initiate security lockdown action

restrict access to and egress from the facility (do not obstruct emergency exits) restrict/confine presence within the site if entry has occurred (move occupants to safe areas of the building restrict contact between the demonstrators and the facility occupants implement specific facility security protocols (cash, critical records, valuable equipment)

Structural faultStructural fault may be brought about by natural disaster, explosions, internal failure or collision. Take immediate refuge under desks or benches, door frames, archways. Do not use lifts. Stay clear of unsecured

items. Chief warden is to notify emergency services Chief warden is to organise injury and damage report if safe to do so Organise check of exits and commence evacuation In all cases of structural damage or fault, contact the Steinhoff Asia Pacific Support Centre Legal & Compliance and

Property departments

Forms and Records

Emergency procedures monthly checklistEmerge n cy Summary Sheet Phone Threat Checklist WHS Activities CalendarEmergency Evacuation Exercise Observers’ ChecklistWHS Induction ChecklistEmergency and Fire Awareness Induction Checklist (TBA)Personal Emergency Evacuation Plan (PEEP)Chief warden and warden cheat sheets

http://intranet.freedom.com.au/ValueSafeIntranet/documents/OHS/OHS%20Risk%20Management/Emergency%20Evacuation%20Exercise%20Observers%20Checklist.doc

Appendix A

You are here

N

Date issued: Version:Validation date:

Legend (delete items that are not applicable)Fire hose reel Emergency exit Assembly area

Fire hydrant Fire indicator panel Switchboard

Fire blanket Emergency phone (WIP) First aid kit

CO2 extinguisher Emergency call point Spill kit

Water extinguisher Fire doors 000 Emergency

Dry chemical powder extinguisher “You are here” Refuge

EVACUATION DIAGRAMNAME:ADDRESS:Assembly Area:

DOCUMENT MANAGEMENT CHECKLIST

SiteManager

Date

CompletedOld WHS documents archived (must be kept for 7 years) Yes No

New policies printed and placed on file Yes No New activities calendar printed Yes No

General cleanliness of folder Yes No

Above activities have been completed

Safety Ambassador

Name:

Signature:

Location Manager

Name:

Signature:

August 2016

WORKPLACE INSPECTION CHECKLIST

Alter this form to suit your environment and save to your own computer.

General Details

Name of Person(s) Conducting Inspection: Date Conducted: / /

Reference: Location:

Identify hazards below. Any item marked with a [N], is a hazard and must be risk assessed and controlled. This is to be documented in the later sections of this form.

Prevention of Slips, Trips, Falls Y/N Comments

Cables and cords not in walk areas.

Reception area free of water, stored boxes, waste bins.

Kitchen floors free of water, spills, stored boxes, waste bins.

Entrance free of water, stored boxes, waste bins.

Hallways free of water, stored boxes, waste bins.

Corridors and walkways free of clutter, boxes and water.

Toilets free of spills and stored boxes.

Are wet floors sign posted where required?

Are emergency exits free from clutter or boxes?

Are tiles, carpet, etc. secure and not loose?

Stairways: Obstruction free, railings and toe boards fitted, non-slip surface, well maintained, no projecting fittings, nails etc.

Are walkways and areas well lit?

Emergency Procedures Y/N Comments

Are extinguishers attached to the wall?

Are hoses wound on the reel?

Have extinguishers and reels been serviced in the last 6 months?

Are evacuation plans clearly visible?

Are staff trained in the use of the emergency equipment?

Are emergency contact details displayed?

Are all exits clearly marked?

Electricity Y/N Comments

Are power points free of overloading (piggy backing)?

Are all cords, cables and extension cords free from visible wear and tear and damage?

Are cables and sockets free of wet areas and heat sources?

Are sockets free of splash areas?

Are all appliances currently tagged?

Are all plugs secured to the wall?Is portable electrical equipment such as microphones and speakers and point of sale equipment protected by safety switches (Residual Current Devices)?Are all power leads and plugs in good condition?Is electrical equipment isolated from elements such as water, sharp edges and cutting devices that can cause shock?Ergonomics Y/N Comments

Are work surfaces designed to suit the height and reach of all staff?

Are work chairs well designed and adjustable?

Is office based equipment selected and adjusted to take into account individual requirements (such as computers)?

Are staff encouraged to take regular rest breaks?

Machinery and Equipment Y/N Comments

Are machine guards in place on all operating equipment and moving parts?Are emergency stop buttons and cut off switches visible and operational?Is ventilation appropriate and adequate for the work area?Are workers trained to operate machinery safely?

Is equipment damaged including wear and tear?

Ladders Y/N Comments

Are feet made of rubber or PVC anti-slip feet and are thick enough to show moulded tread pattern?Are feet securely fastened to the ladder?

Are fastening mechanisms tight so the ladder resists movement when under load?Are the rungs and tread free from foreign material and damage?Are the locking mechanisms used to lock the ladder in an open position free from damage and the fasteners/ pivot points tensioned so the ladder opens easily but not loose enough to cause damage to the ladder stiles?Does the ladder carry the appropriate stickers for commercial use?Does the labelling of the ladder include the manufacturer’s name and address, industrial rating and load capacity and compliance to Australian Standards?Is the ladder used in a stable position?

Is the ladder free from damage?

Hazardous Substances Y/N Comments

Have all hazardous substances been identified, are they labelled and listed in a register?

Are Material Safety Data Sheets (MSDS's) available for each hazardous substance?

Have staff been trained in reading a MSDS, safe handling, storage and disposal procedures for chemicals?

Are records kept of this training?

Is appropriate Personal Protective Equipment (PPE) available, maintained and used?

Are there spillage control procedures in place?

Are these procedures documented and have staff been trained in them?

Are training records kept of this training?

Other hazards Y/N Comments

Are shelves and storage racks secured?

Are boxes and heavy objects stacked on lower shelves?

Are filing cabinets stable when the top drawer is open?

Do all work stations have good lighting?

Are all lights working throughout the office?

Is there good ventilation in all areas?

Caution, information, danger signs appropriate, unobstructed, legible.

Is the photocopier placed in a well ventilated area away from work stations?

Are guillotines appropriately guarded?

Procedure available for tagging faulty equipment?

Clothes lockers, washroom, showers, toilets, drinking fountains clean, tidy and hygienic?

Cooling water system currently tested.Is there a sign in booklet and induction card for all visitors to the store?

Any other hazards?

Any new hazards?

Anything new?

For each hazard identified above marked with a [N], document the risk assessment and control details below.

Risk Assessment and Control

Hazard Risk Controls Date Implemented

Date Reviewed

High Risk H Notify Senior Management immediately. Corrective actions should be taken immediately

Moderate Risk M Notify Location Manager - is to follow up that corrective action is taken within 7 days.

Low Risk L Notify Location Manager – is to follow up that corrective action is taken within a reasonable time.

Review Controls

Location manager verifies controls are effective…….

Effective Not effective

Date: / /

Name:

Signature:

Employee representative verifies controls are effective…….


Date: / /

Name:

Signature:

If not effective, a hazard report form is to be completed and the same reference number allocated for both forms for ease of cross referencing.

Location manager to maintain completed forms and update the Workplace Risk Register.

RECORD OF WHS DISCUSSION (Photocopy this to your WHS Noticeboard)

Instructions (PLEASE READ): Safety meetings form a critical aspect of engaging in two way conversation to staff.

Use this agenda as a guide and tick or highlight the points you discussed. If something is not here you can add it below and any points raised on the second page.

Ensure any follow up points and key info is recorded on page two as being raised in the meetingHint: This does not need to be stand alone meeting, you may incorporate into your normal meetings if convenient.

□ Identify people present

□ Review of actions from last meeting

□ Review all the outcomes of all WHS calendar activities undertaken since previous meetings.

□ Matters raised by in-company inspection/audit and the results of new or revised risk assessments

□ Review of any hazard report forms submitted

□ Review of incident and investigation reports since last meeting – reminder to all to use hazard form and incident reporting on Freecomm

□ Review of workplace Risk Register and where to find it

□ Matters raised by Safety Ambassadors or other representatives of employees

□ New legislation, codes of practice, official guidance, or other information on relevant trade or commercial safety developments (if relevant)

□ Health and safety issues associated with any new materials, processes or systems of work, new or revised layouts and proposals for any new plant or equipment requiring additional action, training or information

□ Contractor or site works coming up (renovations etc)

□ Safety Topic

□ Changes or improvements in fire prevention

□ Review of emergency teams and first aiders

□ other items (please list): ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

1. The date of next meeting

RECORD OF WHS DISCUSSION

Date: Location:

Persons Present:

Name Position Signature

Comments and issues raised:

1.

2.

3.

4.

Corrective Action/s Action CompleteBy who Date Sign off

Name of manager:________________________________

Signature: ________________________________________ Date: _________________

Maintain record of forms in Records Folder

REVIEW RISK REGISTER

This activity simply involves reviewing all incidents and hazards to ensure they have been placed on the risk register. You will also be required to review the existing items on the risk register and ensure that the controls are still effective and if there are any outstanding actions.

Some common faults when reviewing the risk register: You do NOT need to reprint a risk register off the intranet each time you are required to

review the risk register. However, if you do not have a risk register you can print one off as a starting point.

You need to ensure that all hazards from workplace inspections and other calendar activities are transferred onto the risk register.

1. Details of person conducting review

Name of person(s) conducting activity: Date Conducted: / /

Store: Work Area / Task:

2. Risk register review

Inspection Item Y / NN/A Comments

Have all the hazards identified via hazard reports and incident reports been transferred onto the risk register?

Yes No N/A

Are the controls for all the hazards still applicable and still relevant Yes No N/A

Have all hazards identified in monthly activities (eg workplace inspections) been transferred onto the risk register?

Yes No N/A

Are there any risks on the register which require urgent attention of management? If yes, which ones?

Yes No N/A

5. Register reviewed and up to dateLocation manager verifies risks are controlled and up to date…….

Effective Not effective Date: / /

Name:

Signature:



Name:

Signature:

WAREHOUSE EQUIPMENT MAINTENANCE CHECKLIST

Date Check Performed:...../…../….. Checked by:……………………………Piece of Equipment

Checklist TaskYes No N/A Comments

Sack TrolleyAre the wheels fully inflated?Have the tyres suffered any damage? (i.e. Cracks in tyres, low amount of tread etc.)

Is the tyre damage a hazard?Are there any nuts, bolts or other pieces missing from the trolley?Are the wheels operating in a smooth fashion?Is the trolley operating in a smooth fashion and fit for use?Is there any Damage to the trolley?Flat Bed TrolleyAre the wheels in good condition?Are the wheels operating in a smooth fashion?Are there any nuts, bolts or other pieces missing from the trolley?Is there any Damage to the trolley?Is the trolley operating in a smooth fashion and fit for use?Cage TrolleyAre the wheels in good condition?Are the wheels operating in a smooth fashion?Are there any nuts, bolts or other pieces missing from the trolley?Is there any Damage to the trolley?Is the trolley operating in a smooth fashion and fit for use?Pallet JackAre the wheels in good condition?Is the jack arm operating correctlyIs the jack release operating correctly?Is the trolley operating smoothly?(i.e. steering, total control etc.)

Is there any Damage to the trolley?

Signed……………………

September 2016

FIRST AID KIT CONTENTS CHECKLIST

Location: ______________________ Kit Type (circle) A B C

Tick items by month and replace if items have been used

ITEMS REQUIRED IN KIT Kit A*

Kit B*

Kit C* J F M A M J J A S O N D

Adhesive plastic dressing strips, sterile, packets of 50

2 1 1

Adhesive dressing tape, 2.5cm x 5cm

1 1 N/A

Bags, plastic, for amputated parts Small

2 1 1

Medium 2 1 1Large 2 1 N/ADressing, non-adherent, sterile, 7.5cm x 7.5cm

5 2 N/A

Eye pads, sterile 5 2 N/AGauze bandages –5cm

3 1 1

10cm 3 1 N/AGloves, disposable, single 10 4 2Rescue blanket, silver space 1 1 N/ASafety pins, packets 1 1 N/AScissors, blunt/short-nosed, minimum length 12.5cm

1 1 N/A

Splinter forceps, stainless steel 1 1 N/ASterile eyewash solution, 10ml single use ampoules or sachets

12 6 N/A

Swabs, prepacked, antiseptic, packs of 10

1 1 N/A

Triangular bandages, minimum 90cm

8 4 1

Wound dressings, sterile, non-medicated, large

10 3 1

First-aid pamphlet (as issued by St John Ambulance/Australian Red Cross Society)

1 1 1

Initial of person doing check

* ContentsKIT A 100 or more employeesKIT B Between 10 and 100 employeesKIT C Up to 10 employees

First Aid Attendant to maintain original completed forms and a copy maintained by location managers.

SAFETY TRAINING

This monthly activity requires you to review and record the training requirements of all staff at your site to ensure they have received and understand the various safety training modules. Please ensure all freecomm Compliance Training is complete.

Not everyone needs to complete every module. For example, not everyone will be require to complete 1st Aid training or Fire warden training but everyone will be required to complete manual handling training. You may also have some site specific safety practices (eg, a goods lift) which you can place in one of the spare columns.

Below is the process you need to follow:1. Locate all induction forms and ensure they are in the WHS folder, complete the form for

any staff who have not completed them2. Review freecomm modules for each staff member has been completed (you will require a

manager at the site to do this):a. Ensure all Safe Work Practices have been completedb. Ensure WHS Compliance modules are complete

3. Identify your 1st Aider and Fire Warden and ensure they have received training4. If any staff member has a shortfall, advise the staff member to complete the activity as

soon as possible. 5. If you have any site specific SWP or SOP’s (e.g. lifts, hoists etc) make sure relevant

employees are trained and record those who are trained.6. If outside training is required (1st Aid, Fire Warden) then liaise with Dennis Bastas (02 9882

9046) for when the next course is scheduled to be run.

Training is completed and up to dateLocation manager

Date: / /

Name:

Signature:

Employee representative

Date: / /

Name:

Signature:

PRODUCT ASSEMBLY REVIEW

This activity requires each site to physically inspect floor stock which requires assembly. Often in the rush to get stock on the floor, the product can be assembled incorrectly and this can cause a hazard to any users of the product. Ideally, this should be done after major catalogue changes or floor moves.

In order to complete this check, you should do this with at least two people (to provide additional perspective). This activity requires each site to physically inspect floor stock which requires assembly.

Not all items on this list will be applicable to each product. The list is designed to be used as a guide and prompt for things to look for when completing the check.

NOTE: It is important that any product issues are reported to ensure there is not a systemic issue with the product. If you identify any issues during this activity ensure it is reported to Quality.



Store:

Products inspected (name only):

2. Assembled product review


Have all assembled parts been screwed attached correctly? Yes No N/A

Is the product stable and fit for purpose? Yes No N/A

Are there any missing parts? Yes No N/A

Are all wheel based products on suitable flooring? Yes No N/A

Are there any sharp edges or pieces which pose a cutting hazard? Yes No N/A

Check the assembled product with the instructions that accompany the product Yes No N/A

5. Register reviewed and up to date

Location manager verifies risks are controlled and up to date…….


Name:

Signature:



Name:

Signature:

October 2016




Ensure any follow up points and key info is recorded on page two as being raised in the meetingHint: This does not need to be stand alone meeting, you may incorporate into your normal meetings if convenient.












□ Safety Topic






Date: Location:

Persons Present:



1.

2.

3.

4.


Name of manager:________________________________

Signature: ________________________________________ Date: _________________Maintain record of forms in Records Folder

HAZARDOUS SUBSTANCES REGISTER

Product Name

Supplier DetailsSee Label on

product(Name, Address,

Telephone)

Where is the substance used

& stored? (eg. Dishwashing Liquid in Kitchen)

Quantityeg.

240mls

General Nature of Product

Risk Assessed?

Risk Adequately Controlled?

Dangerous Goods Class

UN Number

Date ofMSDS Issue

Eg .CleanerLily Industries

Ph: 02 9999 0000

Used throughout premises and stored

in cleaning room500ml Cleaning

productS&ODate

Yes Class 2 UN567 8 May 07

Location manager to maintain completed forms. Supervisors to maintain copies of this register for relevant substances in their area.

WORKSTATION ERGONOMIC RISK ASSESSMENT FORM

A well designed workstation can help to reduce the risk of discomfort, pain and injury. The following checklist is provided to assist you in setting up and assessing your own workstation ergonomics.

1. General

Name of Staff Member

Name of Manager

Location of Workstation

Date of Assessment

Reference Number

2. Hazard Identification

Daily

List your main daily tasks ......................................................................................................................................

...............................................................................................................................................................................

...............................................................................................................................................................................

...............................................................................................................................................................................

...............................................................................................................................................................................

...............................................................................................................................................................................

Could your daily tasks be varied to help overcome repetitive and prolonged activities?........................Yes / No

Do you change your posture at least every hour? ..................................................................................Yes / No

Are rest breaks and micro pauses taken regularly? ................................................................................Yes / No

Have you incorporated stretching exercises into your workday routine? ...............................................Yes / No

Recommendations ................................................................................................................................................

...............................................................................................................................................................................

...............................................................................................................................................................................

...............................................................................................................................................................................

Chair – Please refer to any instructions that are provided with your chair or have someone show you how to use the controls.

Adjust the height of the seat so that your feet are flat on the floor and thighs are horizontal.

Set the tilt of the seat to horizontal or slightly forward to your own preference

Findings:

Recommendations

Raise the backrest to its maximum height and check if the curve of the backrest fits with the curve of your lower back. If it does not fit lower the backrest until the most comfortable fit is found.

Adjust the position of the backrest until a comfortable pressure is exerted on the lower back while seated at the desk.

The backrest should not push you out of the seat or make you lean back too far. Ensure that there is approximately a 2 finger distance between the front of your chair and the back of your knee.

Findings:

Recommendations

Desk

Your elbow height should be slightly above the level of the desk height. Your shoulders should be relaxed and your elbows bent at 90 degrees.

If you have an adjustable deskYou should raise or lower the height of the desk to slightly below

elbow height.

If you don’t have an adjustable deskWhat is the height difference between your elbow and the desk?

If the desk is too highRaise the chair by the measured difference and use a footrest.

See footrest section below.Or, lower the desk by cutting the legs down by the

measured difference.

If the desk is too lowRaise the height of the desk by extending the leg length or sitting

the desk on blocks. Ensure the changes are stable and secure.

Ensure there is adequate clearance underneath the desk to accommodate your chair and legs. Avoid twisting the spine to reach your work.

Remove any objects that may obstruct you and relocate them to a more suitable position.

Ensure that equipment on your desktop is arranged so that it is within reach. Most frequently used items

should be closer than less frequently used items.

Findings:

Recommendations

Footrest

If you are unable to comfortably place your feet flat on the floor you may need a footrest.

The height of the footrest should be exactly the height of the distance that you raise your seat height.

Findings:

Recommendations

Monitor

The top of the monitor should be positioned so that it is level with your eyes.

Use a monitor stand or object such as telephone books to raise the screen height.

The screen should be placed approximately arms length away from your seated position or to a distance where you do not squint, peer forward or where the screen hurts your eyes.

Ensure the characters on the computer display set at an appropriate size and colour for easy reading

Findings:

Recommendations

Keyboard Use

The keyboard should be aligned with the computer screen and placed directly in front of you near the front edge of the desk.

The feet at the rear of the keyboard should be lowered to reduce the height and angle of the keyboard.

There should be enough room on the desk to move the keyboard away and create room for other tasks.

Findings:

Recommendations

Mouse Use

The mouse should be placed close to your body so as to minimise reach. The arm should be supported by the desk and the wrist in a neutral position.

Ensure the fingers do not hover over the buttons while using the mouse.

Try to learn shortcut keys on the keyboard to reduce mouse use.

Try alternating the mouse between your left and right hand to reduce the time spent in one position. Start slowly and build up over time with your non-dominant hand.

Findings:

Recommendations

Referencing Documents

If you regularly refer to documents while typing you should always try to place the document directly between the keyboard and the computer screen.

An A3 bookrest type document holder (or simply placing the reference documents between the keyboard and screen) is recommended to reduce neck and back twisting when reading from documents.

Findings:

Recommendations

Telephone Operations

The telephone should be placed within or at the optimum reach sector. It should be placed so that you do not have to twist your back to reach or operate it. Try moving your chair if the telephone is not directly in front of you.

Never hold the phone between your neck and shoulder. If you use the telephone for long periods of time you should consider the use of a headset.Findings:

Recommendations

Environment - Your office environment influences your personal comfort and plays a role in your productivity.

Your workstation should be positioned so as to reduce glare and reflections. Place your computer screen in a position so as to maximise light cast over your desk and to avoid reflections on the screen.

Other elements to your working environment should be considered such as lighting, noise, temperature and airflow.

Findings:

Recommendations

Other Findings

3. Risk Assessment and Control


Date Reviewed

Extreme Risk Notify Senior management and Supervisor immediately. Corrective actions should be taken immediately within 24 hours of notification.

High Risk Notify Senior management and Supervisor immediately. Corrective actions should be taken within 48 hours of notification.

Moderate Risk Notify Supervisor - Supervisor is to follow up that corrective action is taken within 7 days.

Low Risk Notify Supervisor – Supervisor is to follow up that corrective action is taken within a reasonable time.

4. Review ControlsSupervisor verifies controls are effective…….


Name:

Signature:

Supervisors to maintain completed forms.

Pictures and checklist sourced from WorkSafe Victoria Officewise- a guide to health and safety in the office

November 2016



General Details























Are feet made of rubber or PVC anti-slip feet and are thick enough to show moulded tread pattern?Are feet securely fastened to the ladder?Are fastening mechanisms tight so the ladder resists movement when under load?Are the rungs and tread free from foreign material and damage?Are the locking mechanisms used to lock the ladder in an open position free from damage and the fasteners/ pivot points tensioned so the ladder opens easily but not loose enough to cause damage to the ladder stiles?Does the ladder carry the appropriate stickers for commercial use?Does the labelling of the ladder include the manufacturer’s name and address, industrial rating and load capacity and compliance to Australian Standards?Is the ladder used in a stable position?
























Any other hazards?

Any new hazards?

Anything new?




Date Reviewed




Review Controls



Date: / /

Name:

Signature:



Date: / /

Name:

Signature:



Self Evaluation Audit Dear Store Manager,

It is important you and your managers become familiar with the MySafety WHS Management System and our compliance requirements.

An audit to assess your implementation of MySafety will take place twice per year; by a Company representative (external audit)). The attached is a copy of the Self Evaluation Record Form, which doubles as your internal audit. The evaluation is important as it;

Ensures we comply as Group with the WHS Strategic Plan

Provides you with an opportunity to show your department managers how to access MySafety as a source of reference

Familiarises your managers with their responsibilities and our Company requirements regarding MySafety

Provides guidance to your managers so that they know how to respond to incidents and avoid fines and claims against you and your location

Serves the purpose of your internal audit for the year

Prepares you for a formal audit which will take place each year.

What you need to do now…

1. Review the attached Self Evaluation Record Form.

2. Ensure you know how to access MySafety on Freedopedia by clicking on the ‘MySafety’ option on the side bar menu.

3. Arrange to meet with your department managers and show them how to access MySafety. Actively ask for their feedback regarding the Self Evaluation criteria. At the end ensure all of your department managers sign the form to acknowledge the evaluation process and how to access MySafety.

4. Work through the Self Evaluation Record Form and keep the completed form in your MySafety Records Folder. Action your summary of findings and items which require corrective action.

SELF EVALUATION RECORD FORM

If any of the questions in the checklist result in a [No] answer then develop controls and enter details on the corrective action sheet at the end.

POLICY AND PLANNING Yes / No / NA Comment

WHS Policy is displayed on the MySafety notice board. Yes No N/A

Consultation Statement is displayed on the MySafety notice board. Yes No N/A

WHS Activities Calendar is drafted and is displayed on the MySafety noticeboard. Yes No N/A

Return to Work (RTW) Statement is displayed on the MySafety notice board. Yes No N/A

Emergency Summary Sheet is filled in and displayed on the MySafety notice board. Yes No N/A

Applicable WorkCover/WorkSafe poster (NSW / VIC / ACT) is displayed on the MySafety notice board.

Yes No N/A

Initial Implementation Plan has been completed. Yes No N/A

WHS and RTW responsibilities are communicated to employees and signed off by employees. Yes No N/A

Formal recognition is awarded to, and disciplinary procedures are administered to, employees on WHS grounds as required.

Yes No N/A

CONSULTATION AND COMMUNICATION Yes / No / NA Comment

Safety Ambassador is identified and available at the site. Yes No N/A

Safety Ambassador has received instruction or guidance on MySafety responsibilities. Yes No N/A

Team meetings / WHS communication has occurred on a regular basis. Yes No N/A

Team meetings / WHS communication record of discussions are maintained. Yes No N/A

Team meetings / WHS communication record of discussions are displayed in an area accessible to employees after each meeting.

Yes No N/A

Use of the Hazard Report Form and Incident Report and Investigation Form is re-iterated regularly at team meetings (verified by inclusion as an agenda item), and submitted forms discussed if appropriate.

Yes No N/A

WHS RISK MANAGEMENT Yes / No / NA Comment

Incident & hazard management and reporting

All incidents are reported and recorded on the Incident Report and Investigation Form. The form is to be completed fully.

Yes No N/A

All identified hazards (through incident investigation) are subject to immediate control and documented on the form.

Yes No N/A

Hazard Report Form completed for all hazards unable to be immediately controlled. Yes No N/A

Workplace Risk Register is completed and regularly reviewed (at least quarterly), and discussed with staff at team meetings.

Yes No N/A

All hazards identified are to be transferred to the Workplace Risk Register. Yes No N/A

Working at height

Hazard Report Form completed for all working at height tasks. Yes No N/A

Employees who work at height have been trained to do so and this has been documented. Yes No N/A

Manual handling

Manual Handling Hazard Management Form completed for all manual handling tasks. Yes No N/A

All employees conducting manual handling have been trained to do so and this has been documented.

Yes No N/A

Contractors

All contractors used are evaluated and listed on a preferred supplier list. Yes No N/A

For all contractors listed, the Contractor Induction Checklist has been completed. Yes No N/A

Contractors maintain a safe work method statement for all works. Yes No N/A

For all contractors working for more than two days or for high risk work, the Contractor Review and Supervision Checklist has been completed.

Yes No N/A

Permit to Work Form/s have been completed, e.g. hot works / welding. Yes No N/A

For all non conformances identified, the Non Conformance Report has been completed. Yes No N/A

Workplace Inspection

Workplace inspections are conducted at least quarterly by the Safety Ambassador and manager, or members of the WHS Committee and manager.

Yes No N/A

Workplace inspections are documented on the Workplace Inspection Checklist. Yes No N/A

Non-conformances are noted on the inspection checklist and corrective action applied and signed off by the location manager.

Yes No N/A

Hazards are transferred to the Workplace Risk Register and are reviewed. Yes No N/A

Plant & equipment

The Plant Hazard Management Form has been completed for all old and new plant (machinery) & equipment hazards.

Yes No N/A

Where appropriate, Safe Operating Procedures (SOPs) are developed for plant and equipment. Yes No N/A

Authorised users lists have been implemented and are up to date for all plant & equipment. Yes No N/A

Safe Work Practices

Where appropriate, Safe Work Practices (SWPs) are developed for high risk tasks based on the results of the risk assessment.

Yes No N/A

Employees have received training in relevant SWPs. This is to be documented. Yes No N/A

Confined spaces

All work associated with confined spaces is managed using the permit to work. Yes No N/A

For all confined spaces tasks, associated risk assessments and controls are documented in the workplace risk register.

Yes No N/A

Ergonomics

Workstation Ergonomic Risk Assessment Form has been completed for all Administration workers and all reported ergonomic hazards / issues.

Yes No N/A

Hazardous substances

A Hazardous Substances Register is available and current. Yes No N/A

All Safety Data Sheets (SDS) are available for hazardous substances. Yes No N/A

All MSDS’s are less than 5 years old. Yes No N/A

All hazardous substances have been subject to risk assessment as indicated on the hazardous substances register.

Yes No N/A

Relevant employees have been trained in the safety requirements of the MSDS. Yes No N/A

All hazardous substances are stored appropriately as per the requirements of the SDS. Yes No N/A

Traffic management

The Workplace Traffic Hazard Management Form has been completed for all traffic hazards. Yes No N/A

Maintenance procedures are in place for each fork lift. Yes No N/A

People working with and in the area of forklifts wear safety footwear. Yes No N/A

Drivers’ licenses are checked regularly for all company vehicle drivers. (NB for P plate and <25yr drivers excess is double).

Yes No N/A

Electrical

Electrical Equipment Service Form is maintained. Yes No N/A

All portable electrical appliances are tested and tagged within the scheduled date. Yes No N/A

Emergency Management

A site specific emergency plan has been developed in line with emergency management procedure in MySafety.

Yes No N/A

All employees have received training and information in the site specific emergency procedures. This is to be documented.

Yes No N/A

Site emergency drills have been conducted at least annually. Yes No N/A

Debrief / results of the emergency drill are discussed at the next team meeting. Yes No N/A

Emergency team members have received formal training, i.e. wardens and first aiders. Yes No N/A

INDUCTION, ON-GOING TRAINING AND COMPETENCY Comment

A training plan is in place for all employees. Yes No N/A

All employees have received WHS induction training. This is to be documented using the WHS Induction Checklist.

Yes No N/A

All formal WHS Committee / elected WHS Representatives have received their statutory training.

Yes No N/A

All training records are available (i.e.: training plan, record forms and completion certificates). Yes No N/A

DOCUMENT MANAGEMENT Comment

A Records Folder is established. Yes No N/A

Documents are controlled and current. Yes No N/A

SELF EVALUATION Comment

Self evaluations conducted as scheduled, records maintained, and actions assigned. Yes No N/A

This is an important section as it relates to how we manage an incident. As well as wanting to prevent injury to people; workers compensation claims generate hefty financial costs.

All managers responsible for injured employees need to know how to complete the Incident Report and Investigation Form thoroughly and report the incident within 24 hours of the incident occurring. If the incident is serious it may be necessary to report the incident to the relevant State WorkCover Authority. Talk to you ROM or Support Centre first.

Incident report forms are an essential part of the WHS and Workers Compensation processes. We must fully complete the investigation and controls section to show how we will prevent a re-occurrence. The form must be fully signed off.

RETURN TO WORK (RTW) AND INJURY MANAGEMENT Comment

First aid facilities consistent with legislative requirements. Yes No N/A

First aid kit contents checked monthly using the First Aid Kit Content Checklist. Yes No N/A

All Incident Report and Investigation Forms are completed and forwarded within 24 hours via the MySafety fax line or email.

Yes No N/A

Return to Work (RTW) Program is available in the workplace (via the Intranet). Yes No N/A

Management involvement in the identification of suitable duties and RTW Plans. Yes No N/A

Managers comply with the requirement of the RTW Plan. Yes No N/A

Self Evaluation Details - General

Name of person responsible for the self evaluation:Date Conducted: / /

Reference: Area / Location:

Summary of Findings

Finding Corrective ActionPerson

ResponsibleDate

CompletedDate for Review

Summary of Findings

Finding Corrective ActionPerson

ResponsibleDate

CompletedDate for Review

By signing below, I acknowledge that:

I have contributed to this Self Evaluation process I understand how to access and make use of MySafety I understand the company requirements for using MySafety

Position Print name Signature Date



Some common faults when reviewing the risk register: You do NOT need to reprint a risk register off the intranet each time you are required

to review the risk register. However, if you do not have a risk register you can print one off as a starting point.








Yes No N/A



Yes No N/A


Yes No N/A



Name:

Signature:



Name:

Signature:

December 2016





Kit B*



2 1 1


1 1 N/A


2 1 1


5 2 N/A


3 1 1


1 1 N/A


12 6 N/A


1 1 N/A


8 4 1


10 3 1


1 1 1





Instructions (PLEASE READ):

Safety meetings form a critical aspect of engaging in two way conversation to staff. Use this agenda as a guide and tick or highlight the points you discussed. If something is not here you can add it

below and any points raised on the second page. Ensure any follow up points and key info is recorded on page two as being raised in the meeting

Hint: This does not need to be stand alone meeting, you may incorporate into your normal meetings if convenient.












□ Safety Topic





Date: Location:

Persons Present:



1.

2.

3.

4.


Name of manager:________________________________


WORKPLACE TRAFFIC HAZARD MANAGEMENT FORM

The following checklist should be used to evaluate workplace traffic hazards in order to assess the potential for injury to occur.

If any of the questions in the checklist result in a [N] answer then:1. a risk assessment must be conducted using section 3 of this form, and2. controls must be devised using section 4 of this form.

1A. Hazard Management Details – General


Reference: Work Area / Task:

1B. Hazard Identification – Analysis of Workplace Records

Records of injuries shall be examined to identify where, and in what jobs, workplace traffic related injuries and incidents have occurred or could occur.

The following factors require consideration (tick as appropriate): any established ‘rights of way’ any exclusion zones the maintenance history of the vehicle involved any vision ‘black spots’ the training and licensing of the vehicle operator any traffic management signage, and any personal protective equipment worn by vehicle operators.

2. Workplace Traffic Hazard Identification (please tick)

2A. Work Environment

Does the workplace have the following?

2a.1 Public car park Yes No N/A

2a.2 Efficient workplace layout/plan? Yes No N/A

2a.3 Floors and surfaces in good condition? Yes No N/A

2a.4 Travel and pedestrian paths identified and clearly marked? Yes No N/A

2a.5 Pedestrian and vehicle exclusion zones? Yes No N/A

2a.6 Designated loading and unloading zones? Yes No N/A

2a.7 Clearly identified ‘right of way’ areas? Yes No N/A

2a.8 Designated maintenance areas? Yes No N/A

2a.9 Identified black spots? Yes No N/A

2a.10 Clear and adequate signage? Yes No N/A

2a.11 Adequate ventilation for the operation of vehicles with internal combustion engines? Yes No N/A

2a.12 Barricades protecting plant and pedestrian walkways? Yes No N/A

2B. Work Processes

Are the work processes?

2b.1 Developed in consultation with operators and employees? Yes No N/A

2b.2 Clearly communicated? Yes No N/A

2b.3 Reviewed for workplace hazards? Yes No N/A

2b.4 Reviewed after implementation? Yes No N/A

2b.5 Incorporated into an overall training program? Yes No N/A

Are systems in place for?

2b.6 Reporting of equipment damage? Yes No N/A

2b.7 Reporting of incidents? Yes No N/A

2b.8 Reporting of stock damage? Yes No N/A

2b.9 Maintenance? Yes No N/A

2b.10 Re-fuelling/recharging? Yes No N/A

2b.11 Managing the safety of bystanders? Yes No N/A

2b.12 The safe introduction of new vehicles (purchasing)? Yes No N/A

2b.13 Training operators? Yes No N/A

2b.14 Assessment of individual loads? Yes No N/A

2b.15 Enforcing speed limits and assessing braking distances? Yes No N/A

2b.16 Assessing vehicle stability? Yes No N/A

2b.17 Not using vehicles with internal combustion engines in poorly ventilated areas? Yes No N/A

2C. Operator

Does the Operator?

2c.1 Understand refuelling /recharging procedures? Yes No N/A

2c.2 Have the authority to operate the equipment? Yes No N/A

2c.3 Have the necessary certifications/qualifications for the particular vehicle? Yes No N/A

2c.4 Understand the workplace rules and requirements? Yes No N/A

2c.5 Understand the workplace layout? Yes No N/A

2c.6 Follow the travel paths correctly? Yes No N/A

2c.7 Control the vehicle appropriately during its operation? Yes No N/A

2c.8 Have the necessary experience with the vehicle? Yes No N/A

2c.9 Use safety devices? (i.e.: seat belts/ horns) Yes No N/A

2c.10 Have knowledge of the operator manual? Yes No N/A

2c.11 Operate at an appropriate speed? Yes No N/A

2c.12 Understand the requirement to report:o Equipment damageo Forklift incidentso Stock damage

Yes No N/A

2D. Individual Factors2e.1 Is the employee new to the work or returning from an extended period

away from work? Yes No N/A

2e.2 Are there age-related factors, disabilities or other special factors that may affect task performance? Yes No N/A

2e.3 Do pedestrians currently observe existing travel paths? Yes No N/A

3. Forklift Management (please complete if you have forklifts)

3A. Forklift and Heavy Vehicle: Pre-operation Checklist3a.1 Do you have a written pre-operational checklist for each type of forklift

and heavy vehicle that is used? Yes No N/A

3a.2 Are these checklists currently in use? Yes No N/A

3a.3 Are the operator manuals readily available? Yes No N/A

Are the following items included in the checklist?

3a.4 Structural damage Yes No N/A

3a.5 Tyres and wheels Yes No N/A

3a.6 Forks/attachments Yes No N/A

3a.7 Chains/cables/hoses Yes No N/A

3a.8 Safety devices (eg: seat belts, warning devices, flashing lights, beepers) Yes No N/A

3a.9 Leaks Yes No N/A

3a.10 Hour metre Yes No N/A

3a .11 Battery/LPG system Yes No N/A

3a.12 Battery connector Yes No N/A

3a.13 Guards Yes No N/A

Does the operator check the following as a minimum?

3a.14 Load rating plate Yes No N/A

3a.15 Steering Yes No N/A

3a.16 Hydraulic oils Yes No N/A

3a.17 Parking brake Yes No N/A

3a.18 Power disconnect Yes No N/A

3a.19 Limit switches (mast, speed, tilt) Yes No N/A

3a.20 Horn Yes No N/A

3a.21 Travel controls Yes No N/A

3a.22 Brakes Yes No N/A

3a.23 Battery charge Yes No N/A

3a.24 Attachments Yes No N/A

4. Risk Assessment Information (please circle)

HIGH MOD LOW

High Risk Notify Senior Management immediately. Corrective actions should be taken within 48 hours of notification.

Moderate Risk Notify Location Manager - is to follow up that corrective action is taken within 7 days.

Low Risk Notify Location Manager – is to follow up that corrective action is taken within a reasonable time.

5. Control Strategy

Please tick….

Eliminate the risk factors.

Pedestrian or vehicle exclusion zones.

Substitute the hazard for other load shifting devices.

Erection of physical barriers.

Speed limits.

Establish pedestrian walkways, ideally with boom gates and right of way rules.

Install traffic management signs.

Install proximity devices.

Warning sign and sirens on forklifts.

High visibility clothing.

Other administrative controls (Signage, Procedures, SWMS).

Other controls.

If controlled immediately list details here.

Date to be implemented: / /

If longer term controls required list here.


6. Review Controls



Name:

Signature:



Name:

Signature:

If not effective, another Workplace Traffic Hazard Management Form is to be completed and the same reference number allocated for both forms for ease of cross referencing.


January 2017

EMERGENCY MANAGEMENT and EVACUATION COORDINATION

NOTE: It is recommended you download this word document and save on your drive. Use the digital copy as the main document and update as required.

PurposeThe purpose of this procedure is to establish, implement and maintain generic procedures for the controlled evacuation of premises arising from foreseeable emergency situations that may pose a threat to the health and safety of employees and non employees. Specific requirements of this procedure will need to be adapted for local requirements.

ScopeThis procedure applies to all operations and staff of Steinhoff Asia Pacific.

Emergencies that could impact on Steinhoff Asia Pacific operations include: fire or explosion robbery or violent incident phone threat electrical failure medical emergency hazardous materials air conditioning contamination civil disorder structural fault, and natural disaster (e.g. earthquakes, flooding).

The workplace/facility that this procedure applies to is:

Name of building/workplace:Address:Telephone number:Hours of operation:Name of building agent:Telephone number of agent:

Fire Safety and Emergency Features

The following fire safety and emergency features are present in this building:

Review

This procedure was last reviewed on:

A review of this procedure must take place at intervals of not more than 5 years.

References Relevant Work Health and Safety Acts & Regulations. Australian Standard 3745-2010 Planning for emergencies in facilities Building Fire Safety Regulation 2008 (Qld)

Responsibilities As part of the emergency procedures, an emergency team has been established to carry out specific tasks whilst the evacuation is taking place. These positions (with names) and their responsibilities include:

Emergency Planning Committee (EPC)

(insert name here) (insert name here)The EPC shall consist of not less than two people who shall be representative of the stakeholders in a facility, one of whom shall be management.The EPC is responsible for: identifying events that could reasonably produce emergency situations developing an emergency plan establishing an Emergency Control Organisation (ECO) to operate in accordance with the emergency plan.

Emergency Control Organisation (ECO)

The primary role of the ECO is to give top priority to the safety of the occupants and visitors of the facility during an emergency. Life safety shall take precedence over asset protection during an emergency. The number of ECO members shall be determined in accordance with the size of the facility, the number of occupants and visitors, the occupants warning system in place and other fire safety features of the facility. The members of the ECO consist of:

Chief Warden / Evacuation Coordinator

(insert name here) The chief warden is responsible for: staff training assessment of emergency deciding to evacuate notifying emergency services, and coordination of emergency services.

The chief warden shall be identified by a white helmet/cap with the words ‘Chief Warden’ labelled. A cheat sheet has been created to be used as a guide in the event of an emergency. It has been designed to be prinited and laminated and located with the wardens hat so in the event of an emergency, the chief has a card which provides guidance on what to do next.

Note: The Chief Warden’s instructions during emergencies shall override normal management structure.

Deputy Chief Warden

(insert name here)The deputy chief warden is responsible for: staff training fire prevention notifying the emergency services notifying the chief warden and management deciding to evacuate, and coordination of personnel for evacuation duties.

The deputy chief warden shall be identified by a white helmet/cap with the words ‘Deputy Chief Warden’ labelled. A cheat sheet has been created to be used as a guide in the event of an emergency. It has been designed to be prinited and laminated and located with the wardens hat so in the event of an emergency, the chief has a card which provides guidance on what to do next.

Area Wardens / Wardens

(insert name here)(insert name here)(insert name here)

Area wardens are responsible for: on becoming aware of an emergency implement the emergency procedure notifying the chief warden of the location and extent of the emergency helping to combat the emergency if trained and if safe to do so, and assisting the deputy chief warden in the above duties.

Area wardens shall be identified by a yellow helmet/cap with the words ‘Area Warden’ labelled. Wardens shall be identified by a red helmet/cap with the words ‘Warden’ labelled. Their area of control shall also be determined as a part of the emergency procedure. A cheat sheet has been created to be used as a guide in the event of an emergency. It has been designed to be prinited and laminated and located with the wardens hat so in the event of an emergency, the warden has a card which provides guidance on what to do next.

Note: Not all locations will require both Area Wardens and Wardens. Smaller locations may manage with Wardens only.

Fire Safety Advisor (Queensland only)

Fire Safety Advisor: (insert name here)Date of training:Work Address:Work Telephone:

In Queensland, the appointment of a Fire Safety Advisor is a legislative requirement under the Building Fire Safety Regulation 2008. The occupier of a high occupancy building or where 30 or more workers are normally employed must appoint a person who is to be trained as the fire safety advisor for the building. If the occupier is the occupier of 2 or more high occupancy buildings, the occupier may appoint the same person as the fire safety advisor for 2 or more of the buildings. The fire safety advisor must be trained in a course in accordance with the Building Fire safety Regulation 2008.

Location Manager

(insert name here)Location managers are responsible for: ensuring an emergency team is established reviewing this procedure as required co-ordinating with the emergency team to conduct drill evacuations annually, and undertaking the role of deputy chief warden if needed with the emergency team to ensure back up of the

chief warden.

Receptionist/Administration

(insert name here)The receptionist is responsible for: notifying the chief warden of the visitors / contractors signed in, and giving the chief warden a copy of the hazardous substance register in the event of an emergency evacuation.

First Aid personnel

(insert name here)(insert name here)

The First Aid personnel are responsible for: undertaking their first aid duties as required during an emergency response or evacuation.

Note: Once an emergency is declared, the powers of all wardens (including the chief warden and deputy wardens) shall override all normal non emergency management procedures. Area wardens shall have the authority to marshal all staff and any visitors to their area. The purpose of these powers is to ensure that during an emergency situation, life safety takes precedent over asset protection and production matters. The procedures require consideration to be given to ensure the protection of wardens, the person or persons refusing to comply, and other personnel in the area when a refusal situation arises.

Procedure Emergency Summary SheetLocation managers are responsible for completing the Emergency Summary Sheet and displaying it permanently in relevant work areas such as the MySafety Noticeboard, staff room and administration area.

Emergency Evacuation DiagramLocation managers are responsible for completing a site specific emergency evacuation diagram for the workplace and displaying it permanently in locations where occupants and visitors are able to view the diagrams, such as the MySafety Noticeboard. The diagram must have the title ‘EVACUATION DIAGRAM’, show the designated emergency exits, the fire fighting equipment, the fire indicator panel and intercommunication system (where installed), any manually operated fire alarms, first aid facilities, the designated assembly area either stated in words or pictorially represented, the validity date of the diagram, and a legend which shall reflect the symbols used. It is also required to show the words “YOU ARE HERE” with an arrow pointing to a red dot on the diagram where the diagram is displayed, and show the exit routes from the place where that diagram is displayed to the nearest exit of the building. The diagram must have the correct orientation with regard to the direction of egress. Assembly areas shall, so far as is reasonably practicable, be sufficiently distant from the emergency for the protection of evacuees.

Refer to Appendix A for an example of an Evacuation Diagram.

Note: A qualified fire safety services and training company may be consulted by the location manager to assist with the development of the emergency evacuation diagram.

Emergency and Fire Awareness TrainingLocation managers are to: ensure emergency training is included in all employee inductions (refer to the WHS Induction Checklist and the

Emergency and Fire Awareness Induction Checklist) ensure all workplace occupants undertake a skills retention activity annually to enable them to act in

accordance with an emergency. This can be facilitated via a team meeting. ensure all wardens are trained in their responsibilities by competent persons (i.e.: external fire services

training provider). This may include first attack and fire extinguisher training

Emergency and Fire Awareness training summaryTraining FrequencyAll employees WHS Induction Checklist Commencement of employmentAll employees Emergency and Fire Awareness Induction Checklist Commencement of employmentGeneral occupant emergency response procedures training AnnuallyECO (Warden and Fire Extinguisher) training 2 year intervalsECO skills retention activity 6 monthly intervalsFire Safety Advisor (Queensland only) Within 1 month of commencement

Warden training is to account for as a minimum: the layout of the area or floor for which they are responsible. They should know the existence of, and the

positions of, rooms leading off blind passages, doors leading to dead ends and other concealed areas in which persons could be located

evacuation routes and safe places the operation of, and procedures for use of, the communications equipment and alarm-initiating devices the number, location and means of assistance for persons with disabilities on their floor or in their area. In

such as case a Personal Emergency Evacuation Plan (PEEP) may be required. the operation of all fire-detection and suppression systems

any special procedures that may exist to protect strategically significant items located in their area any dangerous goods / hazardous substances that may need special attention or isolation, and the operation of portable fire extinguishers, fire hose reels and fire blankets.

Emergency Response Exercises PlanningLocation managers shall schedule emergency response exercises to be held at least annually. These exercises shall be documented on the WHS Activity Calendar.

In addition to the emergency response exercise, the emergency team shall meet at 6 monthly intervals to review the Emergency Procedure, participate in skills retention and revise their responsibilities.

Conducting Emergency Response ExercisesEmergency response exercises shall be conducted in accordance with the schedule in the WHS Activity Calendar. The chief warden shall communicate the following to all area wardens: the identity of the chief warden, the deputy chief warden and each warden alarm system the method of reporting emergencies actions they are to take in response to the alarm signals location of the evacuation meeting point for their area the evacuation route they are to take, and what is required at the completion of the exercise.

The chief warden shall post a notice on the staff notice board with the above details. This shall be done at least one week prior to the exercise.

Area wardens shall then communicate these details within their area of control. This shall also be done at least one week prior to the exercise.

An observer shall be appointed by the chief warden to assess the evacuation exercise. The observer is required to use the Emergency Evacuation Exercise Observers’ Checklist. This form is to be submitted to the chief fire warden at the completion of the exercise. Records of non conformances and the associated corrective action shall be maintained on this form. Location managers are responsible for verifying that all corrective actions are effective.

The exercise shall be conducted in accordance with this procedure.

Emergency EvacuationAll employees are responsible for notifying their warden or their supervisor of emergency scenarios (supervisors will then be responsible for notifying their warden).

Once an emergency scenario has been reported to a warden, the warden is to determine whether emergency procedures are to be activated.

If emergency procedures are to be activated, the warden is to sound the ‘Alert’ signal and notify the chief warden.

Once the ‘Alert’ signal has been activated, wardens and deputy chief warden are to attend their meeting post and await further instruction from the chief warden.

All people on site are to prepare to evacuate, but are to remain in their work area at this time.

The chief warden is to decide whether or not to evacuate.

If the decision is to cancel the evacuation, the ‘Alert’ signal is to be cancelled and a response given to all persons by the chief warden as follows:

“This is the chief warden. An incident was identified earlier and an investigation conducted. You are not required to evacuate. Please return to work and a debrief will be conducted with all wardens. Can all wardens please proceed to the location manager’s office where a debrief will be conducted”.

If the decision to evacuate is executed, the ‘Evacuate’ signal is to be activated and the Emergency Services “000” contacted.

NOTE: in some cases, there may be not be a two-stage ‘Alert/Evacuate’ alarm system but only a single stage ‘Evacuate’ alarm. In this case, the full evacuation is to begin immediately. If there is no emergency alarm at all, alternative procedures must be used to alert occupants of the emergency.

Once the ‘Evacuate’ signal is activated, all persons are required to evacuate to the emergency assembly area.

The warden is to conduct a sweep of their area with the view to: directing all persons to the relevant meeting point identifying any hazards, and assisting injured / disabled persons.

Once the sweep has been conducted, the warden is to proceed to the evacuation meeting point and report back to the chief warden.

At the evacuation assembly area, the wardens conduct a roll call for all persons for their area. They are to ask occupants if they notice anyone who was present prior to the evacuation is now missing. This includes contractors and visitors who have signed in. Any unaccounted for persons are to be reported to the chief warden who in turn reports to the Emergency Services with their likely whereabouts.

Occupants and visitors are not to re-enter the site until allowed by the chief warden.

If the sweep identifies any injured / disabled persons, the warden is to assist those persons to a safe zone (i.e. stair well) and notify the chief warden who in turn notifies the emergency services with location and other details. The warden is to remain with the injured / disabled person until assistance arrives.Any persons requiring first aid will have access to first aid personnel at their evacuation assembly area.

If it is safe to do so, the chief warden will instruct all persons to return to their work area.

Emergency Evacuation Debrief (for actual and drill evacuations)The chief warden is to conduct a documented debrief with all wardens covering the following: the evacuation results as documented on the Emergency Evacuation Exercise Observers’ Checklist the nature of the incident the adequacy of communications the time taken to evacuate the execution of instructions / procedures the adequacy of procedures interaction with external agencies injuries, and any other issues.

Medical EmergencyLocation managers and / or first aiders will call for qualified assistance in a medical emergency.

Employees will co-operate as required with the first aid officers and / or their supervisor.

Location managers and / or first aid officers will advise the ambulance or medical services of: number of people involved suspected condition (i.e.: heart attack or physical injury), and location of where employees / people are.

The injured persons will be assisted to the limit of emergency personnel resources, reassured and made comfortable until qualified assistance arrives. Where injured persons are conscious, and they advise no to assistance, do not proceed.

Robbery or Violent IncidentIn the event of an armed hold up, all employees will be required to adhere to the following procedures at all times: follow Instructions - do exactly what the offender says stay calm and quiet avoid eye contact do not make a sudden movement remain inside the workplace - do not chase the offender show your hands - if you have to move, keep your hands where the offender can see them and tell them what

you are going to do do not attack the offender, and make mental notes - note as much information about the offender as possible, if it is safe to do so. Look at

things like height, hair colour, eyes, physical condition and tattoos/special marks.

Report the incident immediately to your supervisor, only when it is safe to do so.

Location managers have a responsibility to: once safe, call the police seal off the area as vital evidence may be destroyed if this is not done ask witnesses to remain, in order for the police to conduct investigations and have all witnesses write down

their account of the event, before they talk to others about the event have accredited first aid officers treat injured or traumatised people assist in providing post-traumatic stress counselling ensure employees have understood what has happened and update them if necessary. Allow them to make

contact with family members if they wish to do so, and notify the local regulatory authority (i.e.: WorkCover) immediately. Phone ThreatsIn the event of a phone threat the recipient of the call is to attempt to keep the caller on the line for as long as possible by asking the questions listed on the Phone Threat Checklist.

A copy of this form must be kept near the reception telephone.

Meanwhile get the attention of a manager, or someone who can alert the manager that a phone threat is taking place. You can do this by displaying the reverse of the Phone Threat Checklist.

The recipient of the call will need to mentally keep him or herself calm, so that they can focus on getting as much information as possible about the phone threat.

Location managers have a responsibility to: alert the police ensure a search of the premises is conducted, using any information supplied by the caller as a guide, and if any unknown package is found, the manager is to conduct an evacuation of the premises as per the

evacuation procedures.

Electrical failure

In the event of an electrical failure the ECO should undertake the following: chief warden and wardens are to investigate the premises to look for potential sources of power failure

(portable torches will be useful at this time) chief warden is to ask occupants to remain calm and at workstations or in common areas (preferably with

natural light) ask visitors to exit the building or relocate to a common supervised area. Do not allow visitors to continue with

their business, or be allowed to enter the premises during an electrical failure, unless they are seeking refuge. if the failure is not localised, the chief warden is to contact the electricity provider for the site

make announcements on the situation every 10 minutes cease normal operations and processes and focus on people safety and protecting the business and assets. If

there is no need to leave the premises immediately (no physical threat) stay in place until the chief warden has authorised an evacuation to the assembly area or other stop work arrangements. If the premises are equipped with emergency lighting you can remain in the premises. Occupants should not remain in the building after the emergency lights go out.

Hazardous materialsThis may include biological, chemical or radiological substances. Avoid handling the substance – quarantine and confine it. Advise the chief warden Notify the emergency services If the substance has been touched, ensure those people are separated from others and if available washed or

showered. Clothes should be quarantined for analysis. Keep area clear until arrival of emergency services The air conditioning system should be shut down immediately.

Air conditioning contaminationIn the event of air conditioning contamination the Chief Warden is to be contacted, who shall shut down the air conditioning systems immediately, even if the contamination is minimal. Call the Police or Fire Services and request assistance. If the contamination is hazardous or the air conditioning units cannot be over-ridden, it may be necessary to evacuate to the assembly area or another safe area. Be mindful that the cause of the contamination may be outside. Adhere to the Emergency Services instructions.

Civil DisorderCivil disturbances such as protests and forced entry can affect buildings for a variety of reasons includingaffairs of a political, economical and corporate nature. The chief warden should take the following action: notify the Police and request assistance (and Security company if present) alert members of the ECO and management inform facility occupants and visitors of restrictions to be implemented initiate security lockdown action

restrict access to and egress from the facility (do not obstruct emergency exits) restrict/confine presence within the site if entry has occurred (move occupants to safe areas of the

building restrict contact between the demonstrators and the facility occupants implement specific facility security protocols (cash, critical records, valuable equipment)

Structural faultStructural fault may be brought about by natural disaster, explosions, internal failure or collision. Take immediate refuge under desks or benches, door frames, archways. Do not use lifts. Stay clear of

unsecured items. Chief warden is to notify emergency services Chief warden is to organise injury and damage report if safe to do so Organise check of exits and commence evacuation In all cases of structural damage or fault, contact the Steinhoff Asia Pacific Support Centre Legal & Compliance

and Property departments

Forms and RecordsEmergency procedures monthly checklistEmergency Summary Sheet Phone Threat Checklist WHS Activities CalendarEmergency Evacuation Exercise Observers’ Checklist

http://intranet.freedom.com.au/ValueSafeIntranet/documents/OHS/OHS%20Risk%20Management/Emergency%20Evacuation%20Exercise%20Observers%20Checklist.doc

WHS Induction ChecklistEmergency and Fire Awareness Induction Checklist (TBA)Personal Emergency Evacuation Plan (PEEP)Chief warden and warden cheat sheets

Appendix A

You are here

N

Date issued: Version:Validation date:

Legend (delete items that are not applicable)Fire hose reel Emergency exit Assembly area

Fire hydrant Fire indicator panel Switchboard

Fire blanket Emergency phone (WIP) First aid kit

CO2 extinguisher Emergency call point Spill kit

Water extinguisher Fire doors 000 Emergency

Dry chemical powder extinguisher “You are here” Refuge

EVACUATION DIAGRAMNAME:ADDRESS:Assembly Area:

February 2016



General Details






























Any other hazards?

Any new hazards?

Anything new?




Date Reviewed




Review Controls



Date: / /

Name:

Signature:



Date: / /

Name:

Signature:






Ensure any follow up points and key info is recorded on page two as being raised in the meetingHint: This does not need to be stand alone meeting, you may incorporate into your normal meetings if

convenient.












□ Safety Topic






Date: Location:

Persons Present:



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2.

3.

4.


Name of manager:________________________________

Signature: ________________________________________ Date: _________________

Maintain record of forms in Records Folder












Yes No N/A



Yes No N/A


Yes No N/A



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March 2017





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EMERGENCY EVACUATION EXERCISE OBSERVERS’ CHECKLIST

Note: this form is used to assess and record emergency/fire drills. The assessor is to assess the staff effectiveness at conducting the drills.

Floor or Area:

Address:

Observer:

Date:

Ref:

Section A AssessmentEvacuation Sequence Effective Ineffective

Alarm sounded (wardens do so without instruction if required).

Warden(s) respond.

Searches completed.

Simulated call to emergency services completed.

Evacuation commenced.

Wardens report area clear.

Wardens staff evacuation meeting point.

Persons with disabilities accounted for.

Arrive at assembly area, safe place.

Wardens check personnel present.

Wardens report locations of persons with disabilities.

Chief warden appoints person to meet emergency services at front gate.

Evacuation completed.

Exercise terminated.

Other comments……

Observer’s signature:

PLANT HAZARD MANAGEMENT FORM

If any of the questions in the checklist result in a [Y] answer then:1. a risk assessment must be conducted using section 3 of this form, and2. controls must be devised using section 4 of this form.

1. Hazard Management Details - General


Reference: Plant / Equipment:

2. Hazard Identification (please tick).

Inspection Item Y / N / NADescription and Location of the

HazardPHYSICAL HAZARDS

Gravitational – falling person. Yes No N/A

Gravitational – falling object / substance. Yes No N/A

Noise. Yes No N/A

Vibration. Yes No N/A

Radiation sources (x-ray, laser, microwave). Yes No N/A

Ultra-violet light radiation sources (eg: sunlight, welding flash).

Yes No N/A

Manual handling. Yes No N/A

Liquid / air / gas pressure. Yes No N/A

Fire or explosion. Yes No N/A

Thermal. Yes No N/A

Laceration. Yes No N/A

Access / egress. Yes No N/A

Restricted / confined space. Yes No N/A

Operator comfort. Yes No N/A

2. Hazard Identification continued…..

Inspection Item Y / N / NA Description and Location of the Hazard

Air quality. Yes No N/A

Lighting. Yes No N/A

CHEMICAL HAZARDS

Explosive. Yes No N/A

Flammable gas. Yes No N/A

Flammable liquid. Yes No N/A

Flammable solid. Yes No N/A

Reactive. Yes No N/A

Toxic. Yes No N/A

Corrosive. Yes No N/A

MSDS available. Yes No N/A

BIOLOGICAL HAZARDS

Exposure to bacteria / viruses. Yes No N/A

Exposure to fungi / parasites. Yes No N/A

Short / long-term health effects. Yes No N/A

MECHANICAL/ ELECTRICAL HAZARDS

Impact and crushing. Yes No N/A

Shearing. Yes No N/A

Entanglement. Yes No N/A

Laceration. Yes No N/A

Ejected Parts / Materials Yes No N/A

Controls - identification and ease of operation. Yes No N/A

Electricity. Yes No N/A

High frequency radiation source. Yes No N/A

Electro-magnetic radiation. Yes No N/A

2. Hazard Identification continued…..

Inspection Item Y / N / NA Description and Location of the Hazard

PSYCHOLOGICAL HAZARDS.

Operator isolation. Yes No N/A

Noise. Yes No N/A

Interruptions. Yes No N/A

Boring tasks. Yes No N/A

Exposure to assault / verbal abuse. Yes No N/A

Work / production targets. Yes No N/A

3. Risk Assessment Information (please circle)

HIGH MOD LOW

High Risk Notify Senior Management immediately. Corrective actions should be taken immediately.

Moderate Risk Notify Location Manager - is to follow up that corrective action is taken within 7 days.

Low Risk Notify Location Manager – is to follow up that corrective action is taken within a reasonable time.

4. Control StrategyPlease tick: Elimination Substitution Isolation Engineering Administrative PPE (Personal Protective Equipment) (Consider more than one control. Last two controls being least effective)

If controlled immediately list details here.


If longer term controls required list here.


5. Review ControlsLocation manager verifies controls are effective…….


Name:

Signature:



Name:

Signature:

If not effective, another Plant Hazard Management Form is to be completed and the same reference number allocated for both forms for ease of cross referencing.


WAREHOUSE EQUIPMENT MAINTENANCE CHECKLIST

Date Check Performed:...../…../….. Checked by:……………………………Piece of Equipment

Checklist TaskYes No N/A Comments

Sack TrolleyAre the wheels fully inflated?Have the tyres suffered any damage? (i.e. Cracks in tyres, low amount of tread etc.)

Is the tyre damage a hazard?Are there any nuts, bolts or other pieces missing from the trolley?Are the wheels operating in a smooth fashion?Is the trolley operating in a smooth fashion and fit for use?Is there any Damage to the trolley?Flat Bed TrolleyAre the wheels in good condition?Are the wheels operating in a smooth fashion?Are there any nuts, bolts or other pieces missing from the trolley?Is there any Damage to the trolley?Is the trolley operating in a smooth fashion and fit for use?Cage TrolleyAre the wheels in good condition?Are the wheels operating in a smooth fashion?Are there any nuts, bolts or other pieces missing from the trolley?Is there any Damage to the trolley?Is the trolley operating in a smooth fashion and fit for use?Pallet JackAre the wheels in good condition?Is the jack arm operating correctlyIs the jack release operating correctly?Is the trolley operating smoothly?(i.e. steering, total control etc.)

Is there any Damage to the trolley?

Signed……………………

PRODUCT ASSEMBLY REVIEW

This activity requires each site to physically inspect floor stock which requires assembly. Often in the rush to get stock on the floor, the product can be assembled incorrectly and this can cause a hazard to any users of the product. Ideally, this should be done after major catalogue changes or floor moves.

In order to complete this check, you should do this with at least two people (to provide additional perspective). This activity requires each site to physically inspect floor stock which requires assembly.

Not all items on this list will be applicable to each product. The list is designed to be used as a guide and prompt for things to look for when completing the check.

NOTE: It is important that any product issues are reported to ensure there is not a systemic issue with the product. If you identify any issues during this activity ensure it is reported to Quality.



Store:

Products inspected (name only):

2. Assembled product review


Have all assembled parts been screwed attached correctly? Yes No N/A

Is the product stable and fit for purpose? Yes No N/A

Are there any missing parts? Yes No N/A

Are all wheel based products on suitable flooring? Yes No N/A

Are there any sharp edges or pieces which pose a cutting hazard? Yes No N/A

Check the assembled product with the instructions that accompany the product Yes No N/A



Name:

Signature:



Name:

Signature:

April 2017





convenient.












□ Safety Topic






Date: Location:

Persons Present:



1.

2.

3.

4.


Name of manager:________________________________

Signature: ________________________________________ Date: _________________Mainintain record of forms in Records Folder

CONTRACTOR INDUCTION CHECKLIST

SiteContractor

Brief Description of WorksDate

CompletedWork Health and Safety Policy Yes No

Emergency procedures Yes No Hazard and Incident reporting Yes No

First Aid, personnel and facilities Yes No Use of Personal Protective Equipment (PPE) Yes No

Security and Access arrangements Yes No Hazardous Substances on site Yes No

Your site contact Yes No Car parking facilities Yes No

Security requirements (entry and exit from the workplace) Yes No Site Operation Hours Yes No

Nearest toilet Yes No Lunchroom plus general housekeeping Yes No

The fire exits and evacuation procedures Yes No Who your First Aid Officer is Yes No

Who your WHS Committee Representative is Yes No If you require any Personal Protective Equipment (PPE) to be worn Yes No

Check of manual handling techniques Yes No Forklift Safety Procedures Yes No

Appropriate site clothing and footwear Yes No Appropriate Safe Work Statements/Safe Operating Procedures Yes No

Traffic management arrangements Yes No Pedestrian walkways and traffic management Yes No

Information on the above listed items have been provided

Contractor’s Representative

Name:

Signature:

Location Manager

Name:

Signature:

May 2017



General Details






























Any other hazards?

Any new hazards?

Anything new?




Date Reviewed




Review Controls



Date: / /

Name:

Signature:



Date: / /

Name:

Signature:














Yes No N/A



Yes No N/A


Yes No N/A



Name:

Signature:



Name:

Signature:

June 2017





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2 1 1


1 1 N/A


2 1 1


5 2 N/A


3 1 1


1 1 N/A


12 6 N/A


1 1 N/A


8 4 1


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1 1 1








convenient.












□ Safety Topic





Date: Location:

Persons Present:



1.

2.

3.

4.


Name of manager:________________________________
