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Lone Working Risk Assessment Template

This template can be utilised by team managers and safety officers to decrease risks before any accidents or injuries occur. It can assist you as a guide to do the following: List involved lone workers; Evaluate medical fitness, supervision method and training programs in place; Assess the whole location and premise; Recognize any risks present and assign actions to responsible teams; Record proof and findings by taking photos, attaching some notes and finish the report with a digital signature.

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Lone Working Risk Assessment Template


Involved lone worker's name and position:


Supervision: What agreements do you have to keep in contact with the lone worker?
Medical Fitness: Does the loan worker have any medical condition that may put them at heightened risk when working separately?
Training & Competency: Is the lone worker qualified to do the work on his/her own?
Training & Competency : Has essential information, guidance, and training been provided to the lone worker?

Location & Premises

Emergencies: Does the lone worker have admission to emergency warning devices and methods to sound the alarm in event of an emergency e.g. fire alarm, motion sensors /manual device?
Access: Are there a secure means of entrance/egress for the lone worker?
Welfare facilities: Is there sufficient heating, lighting, access to drinking water and toilets?
Building security: Is the building safe and protected?
First aid: Are there arrangements to handle a situation where the lone worker gets ill or has an accident?

Process/Work Activity

Select risks or dangers observed in the workplace
Photo of the documentation (if necessary)


Name and signature of inspector:
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