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Health and Safety Checklist for agency workers form

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Our Health and Safety Checklist for Agency Workers Template ensures compliance and safety standards, safeguarding agency workers in various work environments.

Reading time
How long to understand and implement this form?
5 mins
Word count
How many words in this form?
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What is a Health and Safety Checklist for agency workers form?

The Health and Safety Checklist for agency workers is a tool used to ensure that temporary workers are aware of and compliant with health and safety regulations in their workplace. It covers key aspects such as hazard identification, personal protective equipment (PPE) usage, emergency procedures, and general safety protocols.

This checklist helps to mitigate risks and promote a safe working environment for agency workers, enabling them to perform their duties without compromising their health and well-being.

By systematically addressing health and safety considerations, it contributes to the overall effectiveness and efficiency of temporary staffing arrangements while prioritising worker welfare.

Best practice timescale for this to be issued
When should this form be issued?
At the start of an assignment, to be completed on day 1
Issued by who, to whom
Who should issue this form, and to whom?
The Company (you) to the Candidate
Applicable legal jurisdiction
In which jurisdiction can this form be used?
Great Britain & NI (United Kingdom)

Health and Safety Checklist for agency workers

Assignment Details:

  • Assignment/Job Name: ______________________________
  • Client Name: ______________________________________
  • Assignment Location: _______________________________
  • Date: //____

Health and Safety Checklist:

  1. Personal Protective Equipment (PPE):

    • Ensure you have been provided with appropriate PPE for the assignment.
    • Wear PPE as required, including safety goggles, gloves, helmets, or high-visibility vests.
  2. Work Area Safety:

    • Familiarize yourself with emergency exits, evacuation routes, and assembly points.
    • Ensure work areas are clear of hazards such as trip hazards, spills, or obstructions.
  3. Equipment Safety:

    • Inspect and test equipment before use to ensure it is in good working condition.
    • Follow manufacturer's instructions for safe operation of equipment and machinery.
  4. Chemical Safety:

    • Handle chemicals and hazardous substances in accordance with safety data sheets and instructions.
    • Use appropriate containment measures and personal protective equipment when handling chemicals.
  5. Fire Safety:

    • Identify fire extinguishers, alarms, and emergency exits in the work area.
    • Know how to raise the alarm and evacuate the premises in case of fire.
  6. Manual Handling:

    • Use correct lifting techniques to prevent injuries when handling heavy objects.
    • Use mechanical aids or seek assistance for lifting heavy loads when necessary.
  7. Electrical Safety:

    • Avoid overloading electrical outlets and extension cords.
    • Report any damaged or faulty electrical equipment to your supervisor immediately.
  8. First Aid:

    • Know the location of first aid kits and trained first aiders on site.
    • Report any accidents or injuries to your supervisor and seek medical attention if necessary.
  9. Emergency Procedures:

    • Familiarize yourself with emergency procedures, including evacuation routes and assembly points.
    • Follow instructions from supervisors or designated safety personnel in case of emergencies.
  10. Additional Notes:

[Add any additional health and safety precautions specific to the assignment or client]

Worker Signature: ________________________ Date: //____

Supervisor/Manager Signature: ________________________ Date: //____

Note: This checklist is intended to ensure compliance with health and safety regulations and promote a safe working environment for all agency workers. It should be completed before starting any new assignment and regularly reviewed to address any changes or updates in safety procedures.

Version: [1.0]

Issue date: [date]

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£ 9

Get much more with our
Agency workers template toolkit:
Health and Safety Checklist for agency workers form
health and safety checklist for agency workers form