Health&SafetyInductionChecklistThisformisintendedtoassistNIGcustomersinmaintainingabasicrecordoftheinductiontrainingprovidedtotheiremployeesinrelationtohealth,safety,safeworkingpracticesandassociatedissues.Itisprobablethattheformwillrequiresomealterationtoberelevanttoyourspecifictrade,activities&/orlegislationattachingtosame.Note:thecompletionofthisformisnotintendedtoimplycompliancewithcurrentEmployment,Health&Safety,LocalAuthority,Fire,Equalities,DataProtection,orotherlegislationItisyourdutytoensurethatyoucomplywithallaspectsofcurrentlegislation.Shouldyouhaveanyuncertaintiesinthisregard,wewouldrecommendthatyouconsulttheappropriatelegislationorseekexpertadvicebeforeusingtheform.NameofEmployeeLocation/DepartmentDateofEmploymentJobDescription/TasksPleasetickorinitialtherelevantboxtoconfirmthattheemployeehasbeenshownorprovidedwithinformationandtraininginrelationtothefollowing:Emergencyprocedures:Locationoffireassemblypoint;Raisingthealarm:Firewardens:Locationofalarmpoints:Smokingpolicy:Location/useofextinguishers:Prevention/wastemanagement:Locationofemergencyexits:Hotworkrestrictions:Companyprocedures:Illhealthprocedures/reporting:Firstaiders(introduction):AccidentBook/reporting:Firstaidboxes:Nearmissreporting:GeneralDetails1FireSafety2FirstAidArrangements3Forklift&vehiclemovement:Cleanup/spillprocedure:Machineryhazards:Meaningofsafetysigns¬ices:Onlythoseauthorised/trainedtousemachinery,etc:Housekeeping–walkways,preventionofslips,trips&falls:Correctuseoftools/equipment:Hygiene,skincare,etcElectricalsafety:DrugandAlcoholpolicy:Defectreports/machineisolation:Workplacefood&drinkpolicy:Chemical/otherhazards:Welfarefacilities/workbreaks:COSHH/Healthsurveillance:Orientationtour:Avoidinghandling:Identifyingheightwork:Useofaids/assistancewithlift:Correctuseofsteps/equipment;Correctliftingtechniques:Inspection&defectreporting:Noise:Upperlimbdisorders:Vibration:Displayscreenequipment:Asbestos-register/awareness:Pollution/environmental:Whyneeded/legaldutytowear:Correctuseandfit:Wherewearingismandatory:Reportingdefects/replacement:Care&limitations:EvidencedIssueofequipment:Employeesecurity:Vehiclesafetychecks:Securityofpremises:Drivinglicence/penaltypoints:Visitors/publicsafety:Mobilephone&Satnavpolicy:Reportingconcerns:Eyesight,medicines&illhealth:Cashhandling/holduprisks:RTAprocedures/reporting:WorkplaceandWelfare4ManualHandling&HeightWork5SpecialHazards6PersonalProtectiveEquipment7Security&Driving8Participationandcommunication,e.g.raisingsafetyconcerns:Locationofhealthandsafetynoticeboard:CompanyHealth&Safetypolicy:Companyhealthandsafetyrulesissued,grossmisconductexplained,etc:Riskassessmentsrelevanttoroleissued/read:Safesystems/methodsofworkrelevanttoroleissued&read:Iconfirmbytheundernotedsignaturethatthesubjectsdetailedabovehavebeensatisfactorilyexplainedandareunderstood.Iunderstandhowtoseekfurtherguidanceandinformationintheeventofanyissueswhichmaysubsequentlyarise.EmployeessignatureDateIconfirmbytheundernotedsignaturethatIhaveprovidedthecompanyhealthandsafetyinductiontotheabovenamedemployee.SignaturePrintednameDateSignaturePrintednameDateHealthandSafetyArrangements9NIG100699B/05/13Comments/SpecialNotes10Declarations11RiskControlGuidanceFormsV3.05.13NIGpoliciesareunderwrittenbyUKInsuranceLimited,Registeredoffice:TheWharf,NevilleStreet,LeedsLS14AZ.RegisteredinEnglandNo1179980.UKInsuranceLimitedisauthorisedbythePrudentialRegulationAuthorityandregulatedbytheFinancialConductAuthorityandthePrudentialRegulationAuthority.Callsmayberecorded.
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