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Workplace violence and harassment risk assessment template

Workplace violence and harassment risk assessment template

Use this checklist template to assess where your company stands on protecting its employees against harassment and violence in the workplace. Analyze which actions have to be reviewed, modified and developed.

Use this template
or download pdf
Workplace violence and harassment risk assessment template

Use this checklist template to assess where your company stands on protecting its employees against harassment and violence in the workplace. Analyze which actions have to be reviewed, modified and developed.

Use this template
or download pdf

About the Workplace violence and harassment risk assessment template

Addressing violence and harassment head-on is critical for a healthy work environment. A workplace violence and harassment risk assessment template helps you identify risks and streamline reporting processes. Designed for HR professionals, health and safety officers, and managers, this tool standardizes your evaluations, leading to thorough documentation.

With this template, you can address potential threats efficiently, fostering a respectful and secure workplace. This approach not only enhances safety but also boosts team morale and productivity.

How to use the workplace violence and harassment risk assessment template

To evaluate your safety protocols using the workplace violence and harassment risk assessment template, follow these steps:

  1. Customize the template. Begin by accessing the template in the app and tailoring it to your organization’s specific needs. Focus on relevant risk factors unique to your industry and workplace, such as isolated work environments, dealing with angry customers, or use of dangerous equipment. This customization ensures the assessment is both comprehensive and directly applicable to your environment.
  2. Assign roles and responsibilities. Clearly define who will be responsible for conducting the assessment. Assign this task to key personnel such as safety managers, HR representatives, or department heads. Everyone should understand their responsibilities, promoting accountability and thorough evaluation across all areas.
  3. Conduct comprehensive assessments. Implement the template during scheduled audits, after incidents, or at regular intervals. Collect data from various departments and locations to obtain a well-rounded view of the workplace environment. This systematic approach allows you to identify a wide range of potential issues.
  4. Analyze data and implement actionable plans. Review the gathered data to identify trends, patterns, and areas needing improvement. Develop actionable plans based on these insights, assigning specific tasks and deadlines to relevant teams. This proactive management step ensures timely resolution of identified issues and promotes continuous improvement.
  5. Monitor progress and refine strategies. Regularly revisit completed assessments to track progress and evaluate the effectiveness of interventions. Leverage Lumiform’s analytics features to gain deeper insights into risk trends so you can refine safety protocols over time.

Customizing the workplace violence and harassment risk assessment template

You can easily adapt the workplace violence and harassment risk assessment template to fit your organization’s unique needs.

Start by adding industry-specific questions that address particular challenges. For example, in healthcare, include questions related to patient interactions, while in manufacturing, you might focus on equipment-related risks.

Incorporate your company’s policies and procedures directly into the template. If your organization mandates specific reporting timelines or has unique response protocols, include these details to align the assessment with your existing processes.

For greater accountability, you can add options for digital signatures and photo uploads anywhere in the template. This way, you have a clear record of who completed or approved the assessment. Photo uploads also allow you to document relevant details, such as the physical work environment, potential hazards, or the aftermath of an incident.

Download Lumiform’s workplace violence and harassment risk assessment template today

Adopt a systematic approach to workplace safety by using our expertly crafted template. This tool provides an organized way to assess risks and document findings. By implementing this proactively, you can foster an environment where employees feel secure, empowered, and motivated to contribute their best. Prioritize workplace safety now and unlock the full potential of your team.

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Preview of the template
Workplace Harassment and Violence Risk Assessment
General Information
Name
Site Name
Date
Indicate with a checkmark if this is the initial assessment or a reassessment. Indicate when you conducted the last assessment (if applicable) and when you are planning to conduct the next assessment.
Initial Assessment Date
Reassessment Date
Previous Assessment Date
Next Planned Reassessment Date
Information to Answer the Questions
Answer each question in the workplace risk assessment based on its content. For example, when you read the 39 questions below, ask yourself the following: 1. Do I have it? a. If Yes (I do have it), do I need to review it? i. if Yes (I need to review it), and do I need to modify it? 1. if Yes (I need to modify it), then describe the existing controls and list any action items. 2. if No (I do not need to modify it), then no further action is required. ii. if No (I do not need to review it), then no further action is required. b. If No (I do not have it), do I need to develop one? i. if Yes (I need to develop one), then describe the existing controls and/or list any action items. ii. if No (I do not need to develop one), then no further action is required.
Prevention Policy
Does the employer have a policy addressing workplace harassment and violence, including sexual harassment and domestic violence, containing all elements required by the Work Place Harassment and Violence Prevention Regulations (the Regulations) that is readily available to all employees?
Does the employer communicate to its employees the contents of the harassment and violence prevention policy?
Does the employer ensure by policy and in practice that there is no disciplinary or punitive action against an employee for filing a notice of an occurrence of harassment and violence?
Does the employer require by policy and/or practice that employees report any occurrences of harassment and violence in the workplace?
Emergency Procedures
Does the employer have readily available emergency procedures to address an occurrence that poses or threatens to pose an immediate danger to the health and safety of an employee (for example, a bomb threat, riot, highjack, active shooter, armed threat, robbery, employee distress/ threat of self-harm)?
Training
Are all management and non-management employees trained on the prevention of all forms of workplace harassment and violence, including harassment and violence based on the prohibited grounds under the Canadian Human Rights Act?
Are employers and designated recipients trained on responding to occurrences of harassment and violence?
Are all management and non-management employees trained on civility and respect in the workplace?
Are all management and non-management employees provided training on how to recognize the difference between workplace conflict and harassment and violence?
Are all management employees provided training on how to coach and mitigate workplace conflict that may become harassment and violence, if left unmanaged?
Resolution Process
Does the employer ensure by policy and/or practice that notices of occurrences of harassment and violence can be submitted anonymously?
Does the employer have a designated recipient that has received training before assuming their duties under the Regulations?
Are there alternative avenues for submitting a notice of an occurrence of harassment and violence when the designated recipient is the principal or responding party in the occurrence?
Does the employer respond to all notices of occurrences of harassment and violence?
Does the employer have a formal process to inquire into occurrences of harassment and violence that happen outside of the workplace (for example, cyberbullying outside of work hours)?
Is there a process in place to make the option of conciliation available?
Are the investigators appointed to harassment and violence investigations chosen in accordance with the Regulations?
Physical Work Environment
Is the workplace located in a low-crime area?
Is public access to the workplace restricted?
Are access doors locked or secured after hours?
Is video surveillance and/or security services used to monitor entrances, exits and the surroundings of the workplace?
Is there adequate lighting at all times (or at least during working hours) inside and outside the workplace?
Does the employer have well-lit and secure parking lots available for its employees?
Is there a secure place (such as, a locked area or `personnel access only' area) for employees to safely store their personal belongings?
For all work-related activities occurring outside company premises or outside regular working hours, are there security protocols in place that are shared with employees to mitigate risk?
Are there processes in place to address security gaps?
Type of Work
Is the work free from handling cash and/or other valuables?
Does the work involve transporting people or goods?
Is the work free from direct (such as, in-person) contact with clients?
Are employees trained on procedures to manage angry or aggressive clients (for example, de-escalating techniques)?
Are employees trained on safety precautions to take and procedures to follow when working alone or in small numbers to protect themselves from harassment and violence?
Are employees trained on safety precautions to take and procedures to follow when going onto sites (commercial or residential) where the environment is unknown?
Are employees trained on emergency procedures to be implemented where an occurrence poses an immediate danger or there is a threat of an occurrence posing an immediate danger to the health and safety of an employee?
Psychological Protection
Do management employees receive training on their role to support psychological health?
Does the employer have internal resources available to provide support to employees who experience psychological or emotional stress stemming either from the workplace or their personal lives?
Does the employer periodically survey employees on their satisfaction with the work environment?
Are there specific preventative measures in place to protect employees when they work during times of increased psychological vulnerability, such as under high-stress conditions (for example, seasonal demands, exceptional circumstances, etc.)?
Are there clear lines of reporting to minimize conflicting demands on employees?
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Frequently asked questions

Why is a risk assessment for violence and harassment crucial in the workplace?

It identifies potential risks and evaluates their impact on employee well-being. Implementing controls prevents incidents of violence and harassment. This approach ensures a respectful and safe work environment.

What factors should be included in a violence and harassment risk assessment?

Include threat identification, impact evaluation, and preventive measures. Comprehensive assessments ensure effective risk management. Addressing these factors enhances workplace safety.

How can organizations use risk assessments to prevent workplace harassment?

Organizations can identify risks and implement policies to address them. This proactive strategy supports a respectful and inclusive culture. Preventing harassment improves employee morale and productivity.

How does a risk assessment for violence and harassment support employee training?

It identifies areas where training is needed to prevent and address issues. By focusing on awareness and response, it enhances employee readiness. Effective training fosters a safer and more respectful environment.


This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.
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