Health and Safety Overview Assessment Please enable JavaScript in your browser to complete this form.Business Name: *Industry: *Location: *The city, town or district the businesses office is held. Number of Employees: *Business E-mail Address *EmailConfirm EmailYour Name: *Position: *Phone Number:1. Do you have a TRAINED health and safety person? *Please select your answerYesNoWe have a contracted health and safety personMust be employed by the business1a. If yes, what level are they trained to? NZQA, Rep, co-ordinator etc2. Are all workers inducted and copies of the induction held on file? *Please select your answerYesNoWe only induct our contractorsWe only induct our employeesInducted but nothing held on file2a. Have all workers signed a document (that is held on file) confirming their health and safety responsibilities? *Please select your answerYesNoAdvised but nothing held on file3. Are all workers trained in their respective fields, and certification copies held on file? *Please select your answerYesNoTrained but nothing held on file4. How many trained first aiders do you have at your workplace? **Certifications must be current4a. Are first aid kits available and readily accessible? *Please select your answer YesNo5. Are contractors pre-qualified and copies of relevant certifications held on file? *Please select your answer YesNoYes but nothing held on filePre-qualified = checking the contractor is suitable and trained to carry out any works required PRIOR to any works agreed.6. Do you keep a hazard register? *Please select your answer YesNo6a. Is the hazard register updated at regular intervals? *Please select your answer YesNo6b. Is a copy of an up to date hazard register visible to all workers and provided to contractors? *Please select your answerYesNo7. Do you have a process set up in which workers can report hazards? *Please select your answerYesNo8. Do you complete risk assessments for any business activities that take place outside of 'normal' business operations? *Please select your answerYesNo9. Do you have documented emergency evacuation procedures? *Please select your answerYesNoWorkers advised but nothing documentedNo evacuation processes9a. Do you have an assembly point and do all workers know its location? *Please select your answer YesNoWorkers advised but not contractors9b. Has the fire evacuation plan been approved by the fire department? *Please select your answerYesNoWe know we do not to be approvedIf required, check https://onlineservices.fire.org.nz/Home/EvacuationSchemes for further details10. Are all vehicles, equipment, tools and machinery regularly checked for defects and serviced? *Please select your answer YesNoNothing that requires regular servicingUnsure10a. Are all copies of service records held on file? *Please select your answer YesNoNothing that requires regular servicingUnsure*Proof the items have been serviced10b. Is all PPE regularly checked and maintained? *Please select your answer YesNoNot applicablePPE = Personal Protection Equipment. (Such as; high visibility vests, hard hats, boots, safety glasses, hearing protection etc)11. Have all electrical items been tested and tagged by a qualified electrician? *Please select your answer YesNoNot applicable12. Have processes been set up around product storage, chemicals, tools, sharps? (Where applicable) *Please select your answerYesNo(Chemicals) Yes, but no SDS obtainedProcesses in place but not documentedNot applicableSDS = (Safety Data Sheet) for chemicals. 13. Have all workers completed SOPs where required, and are copies held on file? *Please select your answerYesNoYes, but not documentedNot applicableSOP = Safe Operating Procedure 13a. Is regular refresher training for workers carried out and documented? *Please select your answerYesNoYes, but not documentedNot applicable14. Do you have a documented incident reporting process? *Please select your answerYesNoYes, but not documented14a. Are all workers aware of the incident reporting process? *Please select your answerYesNoYes, but not documented14b. Are you aware of what needs to be reported to the regulatory body, and how to notify them? *Please select your answerYesNoAware of what to report but unsure howRegulatory body = WorkSafe15. Do you carry out regular health and safety communications with employees? *Please select your answer YesNo15a. If you have over 20 employees, do you have a health and safety committee and are you aware of it's operational requirements? Please select your answerYes, we have a committee and we are awareYes, we have a committee and we are NOT awareNo*Only answer if you have over 20 employees16. Is ALL health and safety documentation reviewed on a predetermined schedule? *Please select your answerYesNoUnsure of the frequency requiredHave you downloaded and completed a COVID-19 Safety Plan? *YesNoI need help with one *Available on the SaferKiwis homepage (you will be redirected there on submission of this questionnaire). How did you hear about us?Please select your answerSocial Media (Facebook, LinkedIn etc)Search EngineMagazine/NewspaperRadioWord of MouthOtherCommentsPlease provide us with any further information you feel may be relevant to your assessment. Would like to receive future health and safety updates via e-mailSign me upNot for meEmail *WebsiteSubmit