The Health and Safety Assessment Form is a crucial document required under Canadian occupational health and safety legislation for systematically evaluating workplace safety conditions and compliance. It serves as both a proactive tool for hazard identification and a formal record of safety assessments. This document should be used regularly (typically quarterly or when significant workplace changes occur) to assess various safety aspects including physical hazards, chemical risks, ergonomic factors, and emergency preparedness. The form helps organizations maintain compliance with provincial and federal safety regulations while demonstrating due diligence in protecting worker safety. It's particularly important for documenting identified hazards, risk levels, required control measures, and timelines for implementing corrective actions. The assessment form also serves as evidence of regular safety monitoring and can be crucial in demonstrating compliance during regulatory inspections or investigations.
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1. Assessment Information: Basic details including date, time, location, and assessor information
2. Workplace Identification: Details of the workplace being assessed, including address, department, and responsible personnel
3. General Workplace Conditions: Assessment of basic workplace conditions including lighting, ventilation, housekeeping, and general safety measures
4. Physical Hazards: Evaluation of mechanical, electrical, noise, vibration, and other physical hazards
5. Chemical Hazards: Assessment of chemical substances, storage, handling, and WHMIS compliance
6. Ergonomic Factors: Evaluation of workstation design, manual handling, and repetitive motion risks
7. Emergency Preparedness: Assessment of emergency procedures, equipment, and evacuation plans
8. First Aid Facilities: Evaluation of first aid supplies, facilities, and trained personnel availability
9. Risk Rating Matrix: System for rating identified hazards based on likelihood and severity
10. Corrective Actions: Documentation of required actions, responsibilities, and timelines for addressing identified hazards
1. Biological Hazards: Assessment of exposure to biological agents - required for healthcare, laboratories, and similar settings
2. Confined Space Assessment: Detailed evaluation of confined spaces - required for facilities with confined space work areas
3. Working at Heights: Assessment of fall protection requirements - needed for workplaces with elevated work areas
4. Personal Protective Equipment: Detailed PPE requirements and compliance - optional unless specific hazards require PPE
5. Environmental Conditions: Assessment of outdoor work hazards - required for workplaces with outdoor operations
6. Contractor Safety: Evaluation of contractor-related hazards - needed when external contractors are regularly present
1. Appendix A: Hazard Identification Checklist: Detailed checklist for identifying common workplace hazards
2. Appendix B: Risk Assessment Matrix Guide: Detailed guide for using the risk rating system
3. Appendix C: PPE Requirements Chart: Reference chart for required PPE based on identified hazards
4. Appendix D: Emergency Contact Information: List of emergency contacts and procedures
5. Appendix E: Incident Reporting Forms: Ƶ for reporting safety incidents and near-misses
6. Appendix F: Legislative References: Relevant sections of applicable health and safety legislation
Authors
Relevant legal definitions
Clauses
Relevant Industries
Manufacturing
Construction
Healthcare
Mining
Transportation
Retail
Warehousing
Education
Food Processing
Chemical Industry
Agriculture
Hospitality
Oil and Gas
Public Administration
Professional Services
Relevant Teams
Health and Safety
Operations
Human Resources
Facilities Management
Quality Assurance
Risk Management
Emergency Response
Environmental Health
Production
Maintenance
Legal Compliance
Employee Relations
Relevant Roles
Health and Safety Manager
Workplace Safety Coordinator
Risk Assessment Specialist
Occupational Health Nurse
Environmental Health Officer
Safety Compliance Officer
Operations Manager
Facility Manager
Production Supervisor
Quality Control Manager
Human Resources Director
Plant Manager
Site Safety Representative
Industrial Hygienist
Emergency Response Coordinator
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