Workplace health and safety audit
Workplace health and safety audit
Use this template to ensure a safe work environment for your employees.
Workplace health and safety audit
Use this template to ensure a safe work environment for your employees.
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Audit
Executive Summary
Achievements
There where many good management practices already in place at the time of the audit. These practices have supported the reduction of risk exposure to employees and the efforts of Management should be commended. These practices include:
Critical concerns
The audit has identified a number of issues that need addressing as a matter of urgency. These issues either contain risks for employees and/or liabilities to the organisation:
Summary of improvement actions
In order to support the continuous improvement of the safety system, I would encourage the continuation of the current strategic approach. I would recommend that the organisation consider the following key initiatives when considering future safety plans. These simple but important tasks include:
1.0 - Emergency Planning
Building Fire Safety Regulation 2008 s35 states that the occupier of a building must give general evacuation instructions for the building to each person working in the building at intervals of not more than 1 year. The occupier must give general evacuation instructions for the building to a person who starts working in the building, as soon as practicable but no later than 2 days after the person starts working in the building.
If there is (a) a material change to the location of a fire safety reference point for the building; or (b) the procedures for evacuating the building safely in the event of a fire or hazardous materials emergency, the occupier must give the general evacuation instructions for the building, as changed, to each person working in the building as soon as practicable but no later than 1 month after the change.
The Building Fire Safety Regulation 2008 s44 states that the occupier of the building must ensure that an evacuation practice of
the building is carried out—
• By an appropriate number of persons; and
• In an appropriate way; and
• At intervals of not more than 1 year.
The Building Fire Safety Regulation 2008 s36 states that the occupier of a building to give first-response evacuation instructions for the building to each person working in the building at intervals of not more than 2 years. (Examples of ways in which first-response evacuation instructions may be given by a CD or the internet)
The occupier must give first-response evacuation instructions for the building to a person who starts working in the building, as soon as practicable but no later than 1 month after the person starts working in the building.
If there is a material change to the method of operation of a manually operated fire alarm or fire fighting equipment in the building, the occupier of the building must give the first-response evacuation instructions for the building, as changed, to each person working in the building as soon as practicable but no later than 1 month after the change.
First-response evacuation instructions, for a building, means instructions about the method of operation of manually operated fire alarms and fire fighting equipment in the building, including at least 1 of the following—
(a) Training in the use of the fire alarms and fire fighting equipment;
(b) A demonstration of the use of manually operated fire alarms and fire fighting equipment that are identical, or at least similar to, the fire alarms and fire fighting equipment in the building. Example of a demonstration for paragraph (b)— showing a video about the use of manually operated fire alarms and fire fighting equipment
Queensland Development Code MP 6.1- Maintenance of Fire Safety Installations:-
To set appropriate performance standards for maintenance of fire safety installations for the safe
occupation of buildings and specify the maintenance records required. Details to be recorded annually by building occupants include (a) Prescribed fire safety installations (b) Nominated Australian Standard or relevant maintenance requirement (c) Details of critical defect notices issued (d) Date of rectification of critical defect.
Australian Standards
AS 2293 – Emergency Escape Lighting & Exit Signs
AS 1670.4 - Fire detection, warning, control and intercom systems
Good Management Practices
Recommendation
Are chief wardens and floor wardens appointed and trained for all parts of the workplace and their identities displayed?
Signs indicating types of fire extinguisher, fire blankets and fire hose reels , in good condition and visible
Are all fire extinguishers installed at correct heights AS 2444
Are fire extinguishers appropriate for all flammable substances in the workplace
Fire exits clearly marked,easily opened and clear of obstructions for a distance of 2 meters
Fire exits doors handles push down and doors open out
Does the site have an alarm of any type?
Fire alarm system functioning correctly and tested regularly
Date of the last alarm test (monthly)
Date of last trial emergency evacuation, have records been kept BFSR s45&46 . At least 1/year
Date of the last alarm testing for break glass units
Date of the last emergency exits lights tested (6monthly)
Date of the last sprinkler system tested
Date of the fire hydrant tested (Annual flow test)
Date of the fire hydrant tested (5 Year pressure test)
Records are required to be kept of maintenance and testing of all equipment. BFSR s55
Have all employees been given general evacuation instructions (BFSR s35 (2) and cords kept.
Is there a written emergency plan covering relevant emergency situations, with clear emergency procedures?
Fire and evacuations plans available (BFSR s21)
Have all workers been given first response evacuation instructions ? (BFSR s36 (2))
Are evacuations diagrams displayed and do they meet the BFSR s 18 ?
Is emergency evacuation assembly area signed?
Is emergency evacuation assembly area known to all workers
Is external threat (eg. Bomb) checklist in place near main incoming phone and workers trained in it's usage ?
Have risk assessments identified additional emergency response requirements (site, plant, has sub)
Has local emergency services reviewed site risk ?
Are occupancy limits being complied with?
Has fire safety advisor been appointed
2.0 - Communication and consultation
Work Health & Safety Act 2011, Part 5
The Work Health and Safety Consultation, Cooperation and Coordination Code of Practice is an approved code of practice under section 274 of the Work Health and Safety Act 2011(the WHS Act).
An approved code of practice is a practical guide to achieving the standards of health, safety and welfare required under the WHS Act and the Work Health and Safety Regulations (the WHS Regulations).
A code of practice applies to anyone who has a duty of care in the circumstances described in the code. In most cases, following an approved code of practice would achieve compliance with the health and safety duties in the WHS Act, in relation to the subject matter of the code. Like regulations, codes of practice deal with particular issues and do not cover all hazards or risks which may arise. The health and safety duties require duty holders to consider all risks associated with work, not only those for which regulations and codes of practice exist.
Codes of practice are admissible in court proceedings under the WHS Act and Regulations. Courts may regard a code of practice as evidence of what is known about a hazard, risk or control and may rely on the code in determining what is reasonably practicable in the circumstances to which the code relates.
The WHS Act and Regulations may be complied with by following another method, such as a technical or an industry standard, if it provides an equivalent or higher standard of work health and safety than the code.
An inspector may refer to an approved code of practice when issuing an improvement or prohibition.
Australian Standard 4801 requires an organisation to have:
Documented procedures for employee involvement and consultation in WH&S issues,
Procedures for ensuring that pertinent WHS information is communicated to and from employees and other interested parties.
Appropriated procedures for relevant and timely reporting of information
Established, implemented and maintained procedures for controlling all relevant WH&S documents.
Good Management Practices
Recommendation
Has a work health and safety advisor been appointed and is their identity displayed?
Have safety representatives been elected and identity displayed ?
2.2 - Evacuation procedures discussed regularly? (3 to 4 times a year)
Has a rehabilitation officer been appointed if required ?
Low risk Industry $6.507 million in wages , high risk industry 1.981 million in wages
If yes is the name displayed ?
Have minutes of the last WHS meeting been displayed
Are current policies signed by the appropriate manager and displayed in a prominent position?
Are general safety awareness information alerts incident notices displayed ?
Is safety consultation taking place ?
How?
Are H&S reps included in consultation that effects work group ?
Are there documented procedures for involving and consulting with workers in safety matters?
Are workers consulted with changes in the workplace ?
Are there procedures for controlling all relevant work health and safety documents?
Have safety KPIs been identified and relevant workers been made aware of these targets
3.0 - Incident reporting and accident investigation
To ensure incidents have been recorded and investigated to comply with Work Health and Safety ACT 2011 Part 3 , section 38 and AS4801.
Notifiable incident (s35), means
the death of a person; or
a serious injury or illness of a person; or
dangerous incident.
(1) A person who conducts a business or undertaking must ensure that the regulator is notified immediately after becoming aware that a notifiable incident arising out of the conduct of the business or undertaking has occurred.
(2) The notice must be given in accordance with this section and by the fastest possible means.
Note
See the jurisdictional note in the Appendix.
The notice must be given:
(a) by telephone; or
(b) in writing.
Example
The written notice can be given by facsimile, email or other electronic means
A person giving notice by telephone must:
(a) give the details of the incident requested by the regulator; and
(b) if required by the regulator, give a written notice of the incident within 48 hours of that requirement being made.
(5) A written notice must be in a form, or contain the details, approved by the regulator.
(6) If the regulator receives a notice by telephone and a written notice is not required, the regulator must give the person conducting the business or undertaking
duty to notify of notifiable incidents
Serious bodily injury; or
Work-caused illness; or
Dangerous event.
The WHS Regulation also requires that this approved form be completed and kept by certain persons to record a work injury, work-caused illness or dangerous event. This record must be kept for 1 year.
Part 12 of the Electrical Safety Regulation 2002 (s196)(ES Regulation) requires certain persons to notify the Electrical Safety Office or Workplace Health and Safety Queensland on the approved form of the following incidents –
Serious electrical incident; or
Dangerous electrical event.
The Electrical Safety Regulation (197) also requires that the approved form be completed and kept by certain persons to record a serious electrical incident or dangerous electrical event. This record must be kept for 3 years.
Good Management Practices
Recommendation
Is there a hazard identification and reporting system in place?
Are there incident reporting procedures established?
Do workers have an understanding of what to do if an incident occurs?
Are all incidents including near misses recorded?
Have incident/s near misses been investigated?
Are there incident reporting procedures established?
Is there a system to ensure all controls are implemented and reassessed?
Is there an understanding of the incident / injury reporting requirements to the division of Work Health and Safety ?
Is there an understanding of the incident / injury reporting requirements of the Electrical Safety Act and Regulation?
4.0 - First Aid
Work Health & Safety Reg. 2011 Chapter 3 Part 3.3
An employer must ensure that first aid equipment is reasonably accessible to each of the employer’s workers. The first aid equipment must be appropriate and adequate for the worker and the worker’s work.
The first aid requirements need to comply with the First Aid Code of Practice 2004 and WH&S Reg 2011. Chapter 3 Part 3.3
Good Management Practices
Recommendation
Contents of first aid cabinets clean and orderly?
Date of the last first aid kit check and inspection period
Contents are not past expiry date
Cabinets and their locations are clearly labelled
Cabinets easily accessible and unlocked
Signs identifying the location for first aid room/kits
Is a first aid officer accessible to all workers and work areas at all times ?
Is their identity displayed ?
Number of people trained in first aid/CPR
First aid room is clean and maintained ?
Injury report forms available?
Are all treatments are record and confidential?
5.0 - Housekeeping
Work Health & Safety Reg. 2011 Chapter 3 Part 3.1.2(2) recognises housekeeping as an important part of maintaining a system aimed to reduce or eliminate risk in the workplace. Workers, Supervisors and Managers all have roles to play in maintaining the required housekeeping standards in their work area and in all their activities. Training designed to encourage awareness of the importance of housekeeping, using systems set up at each site, should be included in induction programs. Additional training may be provided as appropriate.
Key methods for maintaining good housekeeping include:
• Allocate responsibility for housekeeping for particular areas to teams or individuals,
• Regular housekeeping inspections and records,
• Process for corrective action for identified hazards based on risk management practices, and
• Barricading areas where spills have created a health and safety hazard. The barricade should be of a standard which will contain the spill and restrict access to the area.
Good Management Practices
Recommendation
Bins are located at suitable points
Bins emptied regularly
Oily rags and combustible refuse in covered metal containers
Spills equipment adequate for all types of spills
Spills cleaned up thoroughly
Floors swept
Are all back areas, corners, unused work areas clear of rubbish
Is there a waste removal plan in place?
Is there regulated waste generated and disposed of in accordance with EPA legislation?
6.0 - Walkways, floors and access
Work Health & Safety Regulations 2011 chapter 3, part 3.1.1 recognises the condition of walkways, floors and access systems, as an important part of maintaining a system aimed to reduce or eliminate risk in the workplace.
This requires a relevant person to ensure that:
(a) There is appropriate, safe and clear access to and from the workplace for each of the relevant persons workers working or about to work at the workplace; and
(b) All other means of access at the workplace are safe and clear.
Good Management Practices
Recommendation
Oil and grease removed
Access to walkways kept clear
Walkways free from obstructions
Are passageways and aisles wide enough?
Walkways adequately and clearly marked ?
Unobstructed vision at intersections
Stairs and risers are in good repair, hand rail available?
Floor surfaces even and uncluttered
Is there a traffic / pedestrian management plan in place ?
Is there clear access to all plant operations, controls and emergency stops?
7.0 - Gas bottles and pressure vessels
Australian Standard 2030: The verification, filling, inspection, testing and maintenance of cylinders for the storage and transport of compressed gasses.
AS 1200 defines a gas cylinder as a particular rigid pressure vessel not exceeding 3000L of water capacity and without openings or integral attachments on the shell other than at the ends, and is designed for the storage and transport of gas under pressure.
Good Management Practices
Recommendation
Does the client use or possess gas bottles and/or pressure vessels
Are the full and empty LPG bottles stored and secured in one area
Are LPG bottles / gas cylinders in date (10 years)
Are hoses in good state of repair
Are portable gas bottles connected properly
Are the full and empty compressed gas cylinders like oxygen and acetylene stored and secured in one area?
Are pressure vessels inspected maintain and registered ?
Have flash arresters been fitted to welding gas lines
Is the storage area appropriately signed
Is there any emergency shut of value installed from gas supply to appliances in an easily accessible location
8.0 - Ergonomics
Employers should undertake a risk management process in order to prevent or minimise the risk of injuries caused by manual tasks. The process involves conducting a risk assessment on manual tasks carried out in the workplace, working out how to address any problems, choosing and implementing appropriate solutions, and following up to check that the solutions work.
Working postures result from task demands and work area design. Posture affects the muscular effort needed to perform a job and how quickly muscles fatigue. Posture is particularly important when forceful and/or repetitious tasks are performed or static postures are maintained. The working posture is therefore important in preventing injury.
The Hazardous Manual Tasks Code of Practice 2011 is available to assist in the identification of hazardous manual tasks and gives instruction on ways to control the risks.
People handling relates to workplace activities in which people are physically moved, supported or restrained. People handling requires someone to use force in order to lift, lower, push, pull or slide another person. All people handling tasks are a potential source of injury, and associated risks should be assessed and managed. Manual Tasks Involving the Handling of People Code of Practice 2001.
Good Management Practices
Recommendation
Have manual handling task been listed and risk assessments performed ?
Frequent lifting, pulling, pushing, dragging of light loads is avoided
Bending or reaching above shoulder height and twisting of the back is avoided?
Measure to prevent occupational overuse syndrome is in place?
Work heigh adjusted to suit size of the worker ?
Controls are well designed and properly positioned
Tools and equipment within easy reach. Is the posture sustained or awkward.
Is the worker required to use repetitive sustained high or sudden force?
Working standing position is avoided where possible
Is the worker performing repetitive movements (2/min)
Awkward loads (e.g. Bulking, moving, hot, difficult to grip) redesign where possible
Mechanical lifting aids available and used where necessary
Is there a safe working procedure in place ?
Have workers been trained in manual handling techniques ?
Procedures for safe team lifts is in place ?
Has manual handling of people been risk assessed ?
Have staff been trained in safe manual handling techniques relating specifically to their job duties?
9.0 - Storage and Racking
WHS legislation recognises use of and access to stacking and storage locations, as an important part of maintaining a system aimed to reduce or eliminate risk in the workplace. compliance to AS/NZ 4084
Good Management Practices
Recommendation
Does the client use any storage or racking system?
Are materials stored in racks and bins wherever possible
Is the SWL placed on racking and correct usage poster in place (AS 4084)
Is racking secure and with edge protection in place
Is there an inspection program in place to ensure damage racking is identified and rectified
Is stock material stored safely esp. at height
Are storage areas designed to minimize manual handling problems (commonly used and heavy items store between mid-thigh and shoulder height )
Are racks , shelves, pallets, etc. in good condition
Are floors around racks , shelves, pallets etc clear of obstructions
10.0 - Signs
Work Health and Safety Regulation 2011, Chapter 3, part 3.2.4
Safety signs are a recognised method of identifying hazards within a workplace and consist of signs, symbolic signs, markings and colour. Signs have a range of applications but should be considered an administrative control only. This section covers the issues associated with the identification of hazards by means of signage with an aim to ensure known hazards are identified by means of signs, markings or colour and that all personnel are familiar with the meaning of safety signs and markings.
The use of appropriate signage will be determined from the risk assessment process. Signage should only be used in conjunction with other control measures. Mill operators should be aware of the language capabilities of employees and signage in other languages or symbols only may be required.
Hazards which can be identified by signage include:
• Physical hazards should be identified by means of colour, in accordance with AS 1318 Use of colour for the marking of physical hazards and the identification of certain equipment in industry
• Confined spaces should be marked as required by AS/NZS 2865 Safe Working in a Confined Space
• Underground services (pipes and cables) should be marked by means of the appropriate marking tape in accordance with AS/NZS 3000 Electrical installations
• Pipes, conduits and ducts should be identified in accordance with AS 1345 Identification of the contents of pipes, conduits and ducts
• Safety signs in accordance with AS 1319 Safety signs for the occupational environment should be installed where required.
Good Management Practices
Recommendation
Are PPE signs installed where appropriate?
Authorized workers only, visitor report to the office area visible?
Public access controls are established for all entrances ?
Plant operations (forklifts, trucks, mobile equipment) signs
Hazchem signs compliant with storage dangerous goods according to Work Health and Safety legislation?
Hazardous /warning signs for plant / chemical in place to alert personnel
Smoking / naked flame restrictions observed
Is the designated smoking area signed ?
Are signs linked with the requirements of the risk assessments ?
A sign register is established and identifies the purpose of the sign ?
11.0 Personal protective equipment and clothing
Work Health and Safety Regulation 2011, Chapter.3, part 3.2.
s44 Provision to workers and use of personal protective equipment
(1) This section applies if personal protective equipment is to be used to minimise a risk to health and safety in relation to work
at a workplace under section 20.
(2) The person conducting a business or undertaking who directs the carrying out of work must provide the personal protective
equipment to workers at the workplace, unless the personal protective equipment has been provided by another person
conducting a business or undertaking.
Maximum penalty—60 penalty units.
Example—equipment that has been provided by a labour hire company
(3) The person conducting the business or undertaking who directs the carrying out of work must ensure that personal
protective equipment provided under subsection (2) is—
(a) selected to minimise risk to health and safety, including by ensuring that the equipment is—
(i) suitable having regard to the nature of the work and any hazard associated with the work; and
(ii) a suitable size and fit and reasonably comfortable for the worker who is to use or wear it; and
(b) maintained, repaired or replaced so that it continues to minimise risk to the worker who uses it, including by ensuring that the equipment is—
(i) clean and hygienic; and
(ii) in good working order; and
(c) used or worn by the worker, so far as is reasonably practicable.
(4) The person conducting a business or undertaking who directs the carrying out of work must provide the worker with
information, training and instruction in the—
(a) proper use and wearing of personal protective equipment; and
(b) the storage and maintenance of personal protective equipment.
Maximum penalty for subsection (4)—60 penalty units.
Good Management Practices
Recommendation
Is supplied where hazard cannot be controlled in any other way
Have the necessary PPE signs been posted ?
Correct and appropriate PPE is supplied
PPE checked and maintained regularly
Employees trained in correct use, fitting and maintenance of PPE
PPE is used in the correct manner
PPE worn by workers when required
Sunscreen, hats and sunglasses provided for out doors work
Is PPE provided where identified in risk assessment
Supervisors monitor compliance to PPE policies
12.0 - Electrical
The Electrical Safety Act 2002 is the legislative framework for electrical safety in Queensland.
The employer has an obligation to ensure that adequate precautions are in place for the exclusions of electrical hazards. That is all electrical equipment; lighting, power outlets etc must be installed by a licensed electrician in accordance with Australian Standard AS 3000 – S.A.A. Wiring Rules, Electrical Safety Code of Practice 2010 - Electrical Work, Electrical Safety Act 2002
Good Management Practices
Recommendation
No frayed or damaged leads
No temporary leads on floor
No leads under strain
No double adapters or piggy-back plugs in use
No broken plugs , sockets or switches
Are there any work areas exposed live electrical equipment or wiring
No electrical leads crossing walkways
Portable equipment and leads tested and tagged
Is there a test and tag register available
Date of last test and tag for power equipment
Is there earth leakage circuit breakers installed (safety switch) to the main electrical board
Is there earth leakage circuit breakers installed (safety switch) to the electrical sub-boards
Are the electrical switchboards locked and secured
Date of the last test on the earth leakage circuit breakers
Date of the last test for the main and sub-boards
Are portable earth leakage devices used , tested and tagged
Is there an electrical isolation procedures in place
Is there an "out of service" procedure for damaged or faulty electrical equipment ?
13.0 - Hazardous Chemicals
Work Health and Safety Regulation 2011, Chapter .7, part 7.1
Hazardous Substances Code of Practice 2003.
Good Management Practices
Recommendation
Is there an up to date register of hazardous chemicals
Are safety data sheets (SDS) provided for all chemicals
Risk assessments completed for hazardous chemicals
Is bulk hazardous chemical storage area bundled and signed
All containers are labelled correctly
Unused or unnecessary substances are disposed of in a safe manner
Workers trained in the use of hazardous chemicals and SDS
Task performed as per safety instructions
Necessary equipment for safe use of substances provided
Where necessary ,PPE provided and maintained
Adequate ventilation is provided
Eye washing and showers are easily accessed , inspected and maintained
Is there a chemical spill kit available
Do procedures exist for the safe clean up of chemicals spills
Is the facility a registrable hazardous substances storage facility
Does it have a hazmat box
When were the contents last updated
Is there required to have placarding, if so, is it placarded
Do storage areas comply with requirements of SDS
14.0 - Office environment
Work Health & Safety Regulations 2011, Chapter 3
Managing the Work Environment and Facilities Code of Practice
Office workers may be exposed to a variety of risks such as:
- Heavy loads & poor ergonomics
- Changes of temperatures (hot/cold)
- Poor lighting and indoor air quality
- Cramped & untidy environments
- Fumes or gases from photocopiers & equipment
- Stress & noise
Good Management Practices
Recommendation
Is the area around photocopier well ventilated to control fumes
Are chairs we'll designed and adjustable
Is there sufficient leg room available
Appropriate adjustable furniture and equipment is available and correctly adjusted
Fault reporting and rectification systems been used
Has an ergonomic risk assessment been undertaken for workstations?
Do you employ workers that either work from home or at remote location ?
15.0 Work Areas and Machinery
All plant needs to conform to the Plant Code of Practice 2005. As per Work Health & Safety Regulations 2011 Chapter 5;
“plant” includes:-
- Machinery, equipment, appliance, pressure vessel, implement and tool; and
- Personal protective equipment; and
- A component of plant and a fitting, connection, accessory or adjunct to plant.
Guide to safeguarding common machinery and plant (2006), Guide to machinery and equipment safety (2007)
Good Management Practices
Recommendation
Floor around machines kept clean and free from clutter
Provision to store waste cut-offs
Tools put away when not in use
Adequate work space around machines
Are there any sharp edges on work benches
Risk assessment completed on all plant / machinery
Are safe work procedures readily available
Have the workers been trained I the safe use of machines they are using
Competency assessments for workers that operate plant
Training and competency evidence kept on file
Is the necessary equipment for safe use of machinery provided
Task performed as per safety instructions
Starting and stopping devices clearly marked and within reach of worker
Emergency stops in place and working (regular testing)
Are emergency stops buttons marked and easily accessible
Are lockout procedures followed for maintenance and repair
Are warning signs in place
Are grab and nip point guarded
Fault porting procedures in place
Are all rotating parts covered
16.0 Mobile Plant and Equipment
All plant needs to conform to the Plant Code of Practice 2005. Work Health & Safety Regulations 2011, Chapter 5 Division 7.
Plant includes:-
- Machinery, equipment, appliance, pressure vessel, implement and tool;
- Personal protective equipment; and
- A component of plant and a fitting, connection, accessory or adjunct to plant.
An industrial truck is an item of mobile equipment designed to move goods, materials and equipment in industry, commerce and other places, but excluding mobile cranes. Industrial trucks come in many forms as mentioned in the Australian Standards AS 1763 - Industrial Trucks
Good Management Practices
Recommendation
Is mobile plant used on site ?
Enter details
Workers adequately trained in use of mobile plant and equipment
Hazardous warning devices working correctly
Risk assessments completed on all mobile plant and equipment
Are faults reported and rectified Ina timely/safe manner
Has the daily per start checklist been completed
Task performed as per safety instructions
Lockout procedures followed for maintenance and repair
Are all rotating parts covered
SWL for lifting or carrying is displayed
Are workers able to produce their licenses (forklift , cranes , trucks )
Are competency assessments completed on workers that operate mobile plant
Are all mobile plant and equipment serviced regularly
Is registrable plant registered ( boilers, building maintenance units, cooling towers, lifts, escalators, cranes, pressure vessels, mobile cranes, tower cranes concrete booms) ?
Do all workers hold prescribed occupations and authorized to operate plant
Is the manufacturers information used in procedures
Safe working procedures readily available
17.0 Cranes and Lifting Equipment ( vehicle jacks , hoist and pedestrian forklift)
To ensure risks associated with mobile cranes, vehicle loading cranes, mobile plant used as cranes and other lifting equipment are managed in accordance with the Work Health and Safety Regulation 2011 Schedule 4, Mobile Crane Code of Practice 2006, Tower Crane Code of Practice 2006, AS1353, AS1418, AS1666.
This includes mobile cranes, gantry cranes, tower cranes and lifting slings and chains
Good Management Practices
Recommendation
Is crane or lifting equipment use on site?
Is there sling and chain register in place ?
Frequency of checks?
Have slings been inspected and tagged within the last three months ? AS 1353 flat synthetic - webbing slings - care and use AS4497.2 Round slings synthetic fibre -care and use
Have chains been inspected and tagged within the last 12 months ? AS 3775 chain slings grade T -care and use. AS 2321 short link chain for lifting purposes
Has lifting equipment training been provided where required ( i.e. pedestrian forklifts , hoist and cranes)
Are slings and chains identified correctly , SWL, start date , etc
Are slings and chains checked on a regular basis ?
Is the equipment serviced on a regular basis ?
How frequently ?
18.0 Transport and Logistics
To ensure transporting operations of the business comply with the Transport Operations (Road Use Management) Act 1995, Transport Operations (Road Use Management – Fatigue Management) Regulation 2008
This includes securing loads, fatigue management, oversized loads, overweight loads and inspection and maintenance.
Good Management Practices
Recommendation
Do you employ drivers ?
Do you have a current drug and alcohol policy?
Have all workers signed off on the policy ?
Have you introduced drug and alcohol testing?
Do you have a register of licenses held by workers ?
Is there a signed speed limit in the area ?
Is it adhered to?
19.0 Ventilation and Extraction
General compliance with Work Health and safety Regulations 2011 .Chapter 3, part 3.1.1 (e)
Ventilation systems should be designed and maintained to comply with Australian Standards AS 1668.2- The Use of Ventilation and Air-conditioning in Buildings and AS 3666 – Air handling and Water Systems of Buildings.
The Australian Standards for maximum concentration of airborne hazardous substances are contained in the National Occupational Health & Safety Commission (Safe Work Australia).
Legionella Guidelines Cooling Towers.
Good Management Practices
Recommendation
Suitable ventilation supplied where required ?
Air conditioning system inspected , tested and maintained regularly
Thermal comfort maintained ( humidity , temperature , air speed , etc. ) temperature between 20- 26 degrees C
Local exhaust ventilation provided where required
Cooling plants risk assessed , cleaned , inspected and maintained ?
Is air quality monitoring required ?
Is dust monitoring / survey required ?
Are procedures developed for ventilation / extraction systems?
20.0 General Lighting
Australian Standards 1680: Interior lighting. (Aust Standards for Lux – Corridors = 40 lux, Offices = 320 Lux, Counters = 240 Lux, Entrance halls = 160 lux Warehousing involving search, storage & receivable tasks = 80 lux, General work bench = 160 lux, Kitchens (food preparation). General compliance with Work Health and safety Regulations 2011 . Chapter 3, part 3.1.1 (d)
Good Management Practices
Recommendation
Conduct light test
Correct level of illumination for the work environment
No direct or reflected glare ?
Light fittings clean and in good condition
Emergency lighting operable
Has lighting survey been undertaken for all work areas?
Is it required?
21.0 Noise and Vibration
Work Health & Safety Regulations 2011, Chapter 4, part 4.1 (Noise) states that an employer must prevent risks to his or her workers from exposure to excessive noise at work. This means employers must take steps to prevent risks to workers' health from exposure to excessive noise at work. The Managing Noise and Preventing Hearing Loss at Work Code of Practice 2011 gives further practical advice on how to identify and manage risks from exposure to noise at work.
Excessive noise means:-
(a) An 8 hour equivalent continuous A-weighted sound pressure level of 85 dB(A)
(b) A C-weighted sound pressure level of 140 dB(C).
Managing Noise and Preventing Hearing Loss at Work Code of Practice 2011.
AS noise levels at or below Leq (8h) 85 db (A)
WHS Reg 2011 s58 Audiometric testing
(1) This section applies in relation to a worker who is frequently required by the person conducting the business or undertaking to use personal protective equipment to protect the worker from the risk of hearing loss associated with noise that exceeds the exposure standard for noise.
(2) The person conducting the business or undertaking who provides the personal protective equipment as a control measure must provide audiometric testing for the worker—
(a) within 3 months of the worker commencing the work; and
(b) in any event, at least every 2 years.
This needs to be undertaken as a matter of urgency after discussion with health and safety representatives and the workers.
And compliance to Managing Noise and Preventing Hearing Loss at Work Code of Practice 2011
Commencement date: 1 January 2012
Good Management Practices
Recommendation
Conduct noise testing
Noise levels while plant / equipment operating
Noise levels while plant equipment not operating
Hearing protection supplied if noise cannot been controlled by other way
Where workers are required to wear hearing protection has audiometric testing been undertaken
Do workers wear hearing protection in areas designated as hearing protection areas?
Is the worker subjected to vibration , whole body or hand-arm
22.0 Ladders , safe working platforms and working at heights
To ensure ladder and safe platform issues have been addressed and comply with the Work Health and Safety Regulation 2011 part 4.4.3(5)(a), Australian Standard 1657: Fixed platforms, walkways, stairwells and ladders: Design, construction and installation and Australian Standard 1892: Portable Ladders.
Good Management Practices
Recommendation
In good state of repair
Non conductive ladders used when working on power equipment
All portable ladders are of industrial standards with SWL marked
Inspected on a regular basis - documented
Used correctly
Designed as per Australian Standard
Working at heights risk assessment undertaken
Are fall prevention devices and /or fall arrests systems provided where working in an area that could result in a fall
Working at height / fall arrest training undertaken
23.0 Scaffolding
To ensure scaffolding issues have been addressed and comply with Work Health and Safety Regulation 2011, schedule 4 part 1, that those erecting scaffolding over 4 meters are certified and Australian Standards AS/NZS 1576: Scaffolding. Must also comply with the Scaffolding Code of Practice 2009
All scaffolding is to be erected by a competent person and hold a prescribed occupation where appropriate
Good Management Practices
Recommendation
Does the client use scaffolding ?
Boards in good condition , not bent or cracked
Guard rail , toe boards in place
Scaffolding workers licensed ( above 4 meters)
Internal ladder installed
Correct height to width (4:1)
Slip resistant surface
Gaps between building and scaffolding correct
Scaffolding safe work method statement utilized for erection , inspection, maintenance and dismantling
Procedures in place to control contractors use of scaffolding
24.0 Confined Spaces and Hot Work
Work Health and Safety Regulation 2011, Chapter 4.3 and Australian Standard: 2865-2009 Safe working in a confined space. Australian Standards AS 2865– Safe working in a confined space.
Confined space – a space of any volume which:
- Is not intended as a regular workplace
- Has restricted means for entry and exit
- May have inadequate and/or an atmosphere which is either contaminated or oxygen-deficient is at atmospheric pressure during occupancy
Good Management Practices
Recommendation
Is there any confined space on site ?
All confined space entries are risk assessed
All workers including look outs are trained in confined spaces procedures
Entry and exit procedures adequate
Confined space entry permit completed prior to entry into confined space ?
Rescue equipment readily available a all times
Entry and exit procedures followed
Emergency rescue procedures in place are adequate and practiced regularly
Air fed respirators , if required , are supplied
Is air quality monitored
Hot work areas identified
Hot work procedures established
25.0 Excavations
To ensure excavations issues have been addressed and comply with Work Health and Safety Regulation 2011, chapter 6, division 3.
An EXCAVATION is the cavity formed after the removal of soil or rock. Excavations include trenches, pits and bored pier holes.
Good Management Practices
Recommendation
Does the client conduct any excavation work ?
Excavation procedures established
Safe work method statement developed for excavations
Systems established to control contractors performing work in excavations
Shoring and barricading in place
Warning systems
Warning lights installed (if appropriate)
Public access restrictions in place
Safe access to and from excavation (ladders)
26.0 Sanitation and Amenities
Ensure situation & amenities issues have been addressed and comply with Work Health and Safety Regulation 2011 , Chapter 3, part 3.1.2 (1)
amenities
(1) A relevant person who is an employer and who makes an amenity available and must ensure that the amenity is maintained..
(2) An amenity must be maintained in a hygienic, safe and serviceable condition, including by ensuring that there is a system for—
(a) inspecting and cleaning the amenity; and
(b) if the amenity has facilities to dispose of sanitary items for females—the adequate and hygienic disposal of the sanitary items.
Good Management Practices
Recommendation
Are adequate lunch facilities provided
Is the equipment and furniture , such as fridges and seating maintained in good condition?
Are an appropriate number of toilets available and accessible
Are showers and washing facilities provided where necessary
Washrooms , lockers and toilets clean and maintained
Are consumables such a soap and toilet paper supplied regularly ?
Are lunch rooms clean and tidy
Rubbish bins available and covered
Feminine hygiene bins available
Drinking water available and accessible
Is there water clean, cool and hygienically provided
27.0 Security
Controls should be established to prevent unauthorised persons exposing themselves or others to risk. This may include control of person to and from the site, control of where persons go when they are on site or control of public risk.
Good Management Practices
Recommendation
Visitors and contractors sign in /out unused and available
Security measures in place (cameras etc.)
Adequate lighting within and around workplaces
Workers not working alone or in isolation where possible
Warning signs in place
Footpaths clean and free from rubbish
Appropriate fencing and gates , secured and in good repair
Car parks well lit and secure
Public access controls in place
28.0 Due Diligence
Ensure a System of workplace review is implemented and is adequate for the management of health and safety to comply with the Work Health and Safety Act 2011, Work Health and Safety Regulation 2011, and Australian Standards including AS4801.
Workplace health and safety is ensured when persons are free from—
(a) death, injury or illness caused by any workplace, relevant workplace area, work activities, or plant or substances for use at a relevant place; and
(b) risk of death, injury or illness created by any workplace, relevant workplace area, work activities, or plant or substances for use at a relevant place..
Managing exposure to risks
(1) To properly manage exposure to risks, a person must—
(a) identify hazards; and
(b) assess risks that may result because of the hazards; and
(c) decide on appropriate control measures to prevent, or minimise the level of, the risks; and
(d) implement control measures; and
(e) monitor and review the effectiveness of the measures.
A formal process is required for WH&S Consultation with staff as outlined in the Work Health and Safety Consultation, Cooperation and Coordination Code of Practice 2011
Australian Standard 4801 requires:
• Identification of hazard risks - an organisation to establish, implement and maintain documented procedures for hazard identification, hazard / risk assessment and control of hazards / risk activities, products and services over which an organisation has control or influence, including activities, products or services of contractors and suppliers.
• Legal and other requirements - an organisation to establish, implement and maintain procedures to identify and have access to all or services including relevant relationships with contractors and suppliers. The organisation shall keep the information up to date.
• Objectives and targets – an organisation shall establish, implements and maintain documented OHS objectives and targets
• WH&S management plans – an organisation shall establish and maintain management plans for achieving its objective and targets.
Good Management Practices
Recommendation
Do PCBU and officers understand their obligations under WH&S legislation
Do they have knowledge of health and safety issues relating to the company
Do they understand the operations and associated hazards and risks
Have they ensured that appropriate sources and processes are used to eliminate or minimize risks to health and safety
Have they implemented processes for receiving and responding to information about incidents , hazards and risks
Are compliance processes established and maintained
How can the above be verified
A risk management approach has been implemented as to how work is performed
Injury management program implemented
Statistical analysis of safety performance is undertaken
Employees , contractors and visitors are being inducted
All work areas are inspected regularly for hazards
Has the issue resolution procedure been communicated to the business
Safety policy available ?
Smoking , drugs and alcohol , rehabilitation policy available?
Skin protection , EEO and Discrimination , manual handling policy available?
Sharps policy/ procedure required ?
Is it available ?
Staff induction manual available
Training records are maintained and updated
Are registers established (mobile equipment, fixed plant, ladders, hazardous substances ,high risk plant, confined spaces )
Weekly maintenance checklist u to date and field
Register of safe work procedures available
Register of risk assessment for mobile plant , equipment and machinery available
Schedule in place for servicing eg. ( fire equipment, pest controls , plant and equipment, air conditioners )
29.0 Asbestos Management
The requirements for the management of asbestos in the workplace is established the following:
• Work Health & Safety Regulation 2011 Chapter 8,
• How to Manage and Control Asbestos in the Workplace Code of Practice 2011
The latest Asbestos Codes of Practice How to Manage and Control Asbestos in the Workplace Code of Practice 2011
Commencement date: 1 January 2012 It is now mandatory for all commercial buildings built prior to Dec 31 2003 to be inspected for the presence of asbestos containing materials.
Good Management Practices
Recommendation
Was the building constructed prior to 2003 ?
Is an asbestos register available ?
Is the register reviewed every 12 months
Have workers been trained in asbestos awareness
Safe working procedures for asbestos management
Identified material labelled
Risk management completed for identified material
Contractors /sub contractors manual available
30.0 Lead
The requirements for the management of lead in the workplace is established the following:
To ensure that appropriate systems are in place according to Work Health and Safety Regulation 2011, Part 7.2 Lead require that:
• SDS is available
• Registers are maintained
• Containers are labelled
• Risk assessments are undertaken
• Records are maintained for 30 years
• Exposure is controlled
• Atmosphere is monitored
• Health surveillance is undertaken for workers
• Confidentiality of records
• Induction and training
Good Management Practices / Recommendations
Are there any lead products on site?
Is a lead process being carried out at this workplace ?
Is there a lead register with copy of SDS's
Has a SDS been obtained for all products
Is health surveillance been undertaken
Has the site been registered as a lead site with Queensland workplace Health and safety
Are staff aware of the risks posed by working with lead ?
31.0 Safety Policy (AS4801)
Australian Standard 4801 requires a Work Health and Safety Policy (referred to as OH&S) by the organisations Management that clearly states the OHS objectives and demonstrates a commitment to improving WH&S performance.
The policy shall:
• Be appropriate to the nature and scale of the organisation
• Include the commitment to establish measurable objectives and targets to ensure continued improvement
• Include a commitment to comply with relevant WH&S legislation
• Be documented, implemented, maintained and communicated to all employees
• Be available to interested parties, and
• Be reviewed periodically.
Good Management Practices
Recommendation
Has a safety policy been established for the business
Is it appropriate for the nature and scale of the business
Is there a commitment to establish measurable objectives to ensure continuos improvement
Is there a commitment to comply with safety legislation
Has the policy been communicated with all workers
Is the policy dated and reviewed periodically
32.0 Structure and responsibility (AS4801)
Australian Standard 4801 requires an organisation to
• Identify and provide the resources required to implement, maintain and improve the safety management system,
• Define, document and communicate the areas of accountability and responsibility for employees and contractors.
Good Management Practices
Recommendation
Is there a commitment to provide the resources required to implement , maintain and improve the safety management system
Have areas of responsibility been allocated to persons in control
Are persons identified to ensure contractor compliance
Do job descriptions of managers include WH&S obligations
33.0 Training and competency (AS4801)
The Employer’s duty for training in prescribed activity states “An employer who employs, or otherwise allows, a worker to perform a prescribed activity must ensure the person has received appropriate training in safe working methods for the performance of the prescribed activity”.
The “Plant Code of Practice 2005” defines employer’s obligations to ensure employees are trained and competent.
Australian Standard 4801 requires an organisation to
• Identify training needs in relation to performing work activities competently, including WH&S training, and
• Ensure that all personnel (including contractors and visitors) have undertaken training appropriate to the identified needs.
Good Management Practices
Recommendation
Has management in consultation with workers undertaken a training needs assessment in relation to performing work activities competently including WH&S training?
Are procedures in place to ensure competencies are developed and maintained ?
Has the organization ensured that all workers and visitors have undertaken training appropriate to the identified needs ?
Is training delivered by persons with appropriate knowledge , skills , experience and training?
Is training delivered by persons with a appropriate knowledge , skills , experience and training?
Is training assessed to ensure evidence of competency ?
Is competency evidence signed by the trainee and kept on file?
OUR COMMITMENT TO YOUR PRIVACY
As a client of Maintenance and Project Engineering we are committed to ensuring the privacy of your information and we understand how important the privacy of your personal information is to you and your staff. With the introduction of the amendments to the Privacy Act 1988 we have appointed a Privacy Officer who will ensure our policies are adhered to.
You can be assured, as a client of Maintenance and Project Engineering that we will make every reasonable effort to protect and keep confidential any information you provide to us. We will not sell or release your name or any of your staff names or information pertaining to either any outside organisations except for the purposes of our own analysis (and in these cases will only do so in aggregate form without identifying individual clients), or when external companies offer a product or service which we consider would be beneficial or of interest to our clients.
The following statement addresses the relevant privacy policies Maintenance and Project Engineering has in place to protect your personal information, whether it was gained via mail, e-mail, fax, telephone or a visit to an office. If you have any questions relating to this privacy statement, please do not hesitate to contact us.
WHY DO WE COLLECT PERSONAL INFORMATION?
Our primary objective in collecting personal information from you is to provide you with the most effective service and ensuring our documentation and advice to you is for the correct legal entity.
RESPONSIBLE USE OF INFORMATION
With your consent, we may use your contact/personal details to send you information about our company and services that we feel may be of interest to you, and to contact you from time to time to obtain your feedback about our products and services. We may disclose personal information to third parties when we contract out some functions and activities, such as names and addresses to mailing houses to mail information about our company or for audit purposes to ensure integrity of our business operation.
We will not use your personal information for any purpose which is not related to the products or services we provided to you or for any purpose for which you would not reasonably expect us to use the information. However, your information may be used to enable Maintenance and Project Engineering to offer you other products and services that will enhance our relationship with you. It is your decision whether you wish us to provide this service to you. We may release information about you where there is a duty to the public to disclose that information, where we are required or authorized by law or where the interest of Maintenance and Project Engineering requires disclosure.
We reserve the right, unless specifically advised otherwise, to send you further information on Maintenance and Project Engineering products and services.
INFORMATION REQUESTED BY ANOTHER ORGANISATION
Your personal information will be treated with respect and will not be disclosed to any other individual or organization without express written consent, or as we are legally obliged to do.
QUALITY OF PERSONAL INFORMATION
Our priority is to ensure that your personal information is accurate, complete and current. To assist us with this, please advise us if any of the details you have provided change. Further, if you believe that the information we have about you is not accurate, complete or up to date, please contact us and we will take all reasonable steps to correct the information.
CONTACT INFORMATION
If you have any questions about this privacy statement, or your dealings with Maintenance and Project Engineering you can contact us via the following methods:
Postal: PO Box 565 Oxenford QLD 4210
Phone: (07) 55800490
Fax: (07) 55800491
COPYRIGHT STATEMENT
Copyright on this document is owned by Maintenance and Project Engineering No part may be reproduced, or stored, whether electronically or by any other process, without the written permission of Maintenance and Project Engineering . © as permitted under the Copyright Act 1968 (Cth).
Written requests for permission should be addressed to:
Maintenance and Project Engineering
PO Box 565
Oxenford 4210
E-mail: Tony@mpe.com.au
DISCLAIMER OF LIABILITY
Maintenance and Project Engineering accepts no responsibility for the results of any actions taken on the basis of any material, information or advice provided by Maintenance and Project Engineering or for the accuracy or completeness of the material, information or advice. Before relying on the material, information or advice, or any part of it, you should independently verify its accuracy and/or completeness.
Maintenance and Project Engineering expressly disclaims all and any liability and responsibility to any person or legal entity, in respect of the consequences of anything done or omitted to be done, by such person or legal entity, in reliance, whether wholly or partially, upon information or advice provided by Maintenance and Project Engineering
To the full extent permitted by law, Maintenance and Project Engineering excludes any liability arising from the use of, or reliance on, any material, information or advice provided by Maintenance and Project Engineering Where liability cannot be excluded our liability is limited to the resupply of the said material, information or advice.
Maintenance and Project Engineering, will not be liable for any indirect or consequential loss, including loss of profits arising out of the use of any material, information or advice provided by Maintenance and Project Engineering
Your workplace health and safety obligations are not diminished by –
a) the appointment of Maintenance and Project Engineering ; or
b) any act or omission of a person acting on behalf of Maintenance and Project Engineering in any role whatsoever.
The Directors, Management and Staff
Maintenance and Project Engineering
REFERENCES
Legislation: (www.legislation.qld.gov.au )
Building Act 1975
Building Fire Safety Regulations 2008
Electrical Safety Act 2002
Electrical Safety Regulations 2002
Workers Compensation and Rehabilitation Act 2003
Workers Compensation and Rehabilitation Regulation 2003
Work Health and Safety Act 2011
Work Health and Safety Regulation 2011
Australian Standards: (www.saiglobal.com )
AS/NZS 1200 Pressure Equipment
AS 1219 Power Presses – Safety Requirements
AS 1319 Safety Signs for the Occupational Environment.
AS 1418 Cranes (including Hoists and Winches)
AS 1473.1 Wood Processing Machinery - Primary Timber Milling Machinery
AS/NZS 1576.1 Scaffolding – General Requirements
AS 1657 Fixed Platforms, Walkways, Stairways and Ladders – Design, Construction and Installation
AS 1668.2 The Use of Ventilation and Air Conditioning in Buildings
AS 1680 Lighting
AS 1680.2.2 Interior and Workplace lighting – Office and screen-based Tasks
AS/NZS 1680.2.4 Interior and Workplace Lighting - Industrial Tasks and Processes
AS 1763 Industrial Trucks
AS 1873 Power Actuated (PA) Hand Held Fastening Tools
AS 1891 Industrial safety belts and harnesses
AS/NZS 1892.1 Portable ladders – Metal.
AS 1940 The Storage and Handling of Flammable and Combustible Liquids
AS 2030.1 The verification, filling, inspection, testing and maintenance of cylinders for storage and transport of compressed gasses.
AS 2293 Emergency Escape Lighting and Exit Signs
AS 2550 Cranes – Safe Use
AS 2596 Seat Belts for use in Motor Vehicles
AS/NZS 2865 Safe working in a confined space
AS 2958 Earthmoving Machinery - Safety
AS/NZS 3000 Electrical installations – Wiring rules
AS/NZS 3666.2 Air-handling and water systems of buildings – Microbial control – Operation and Maintenance
AS 3509 LP (Liquidified Petroleum) gas fuel vessels for automotive use
AS 3745 Emergency control organisation and procedures for buildings, structures and workplaces.
AS/NZS 3760 In-service safety inspection and testing of electrical equipment
AS 4024.1 Safety of Machinery
AS 4576 Guidelines for Scaffolding
AS/NZS 4801 Occupational Health and Management Systems – Specification with guidance for use
Codes of Practice:
First Aid Code of Practice 2004.
Forest Harvesting Code of Practice 2007.
Hazardous Substances Code of Practice 2003.
Hazardous Manual Tasks Code of Practice 2011.
Manual Tasks Involving Handling People Code of Practice 2001.
Managing Noise and Preventing Hearing Loss at Work Code of practice 2011.
Managing the Work Environment and Facilities Code of Practice 2011
Plant Code of Practice 2005.
How to Manage Work Health and Safety Risks Code of Practice 2011.
Scaffolding Code of Practice 2009.
Work Health and Safety Consultation, Cooperation and Coordination Code of Practice 2011
Confined Spaces Code of Practice 2011
How to Manage and Control Asbestos in the Workplace Code of Practice 2011
How to Safely Remove Asbestos Code of Practice 2011
Labeling of the Workplace Hazardous Chemicals Code of Practice 2011
Managing the Risk of Falls at Workplace Code of Practice 2011
Preparation of Safety Data Sheets for Hazardous Chemicals Code of Practice 2011
Recreational Diving, Recreational Technical Diving and Snorkeling Code of Practice 2011
Abrasive Blasting Code of Practice 2004
Cash in Transit Code of Practice 2011
Children and Young Workers Code of Practice 2006
Concrete Pumping Code of Practice 2005
Formwork Code of Practice 2006
Foundry Code of Practice 2004
Horse Riding Schools, Trail Riding Establishments and Horse Hiring Establishments Code of Practice 2002
Mobile Crane code of Practice 2006
Occupational Diving Work Code of Practice 2006
Prevention of Workplace Harassment Code of Practice 2004
Rural Plant Code of Practice 2004
Safe Design and Operation of Tractors Code of Practice 2004
Sugar Industry Code of Practice 2005
Tilt up and Precast Construction Code of Practice 2003
Tower Crane Code of Practice 2006
Traffic Management for Construction or Maintenance Work Code of Practice 2008
Tunneling Code of Practice 2007
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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.