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Instructions:
This Checklist is designed as an Occupational Health and Safety and risk assessment checklist for Supporters requesting services in clients’ homes.
Please enter a tick or a cross to indicate conformance or non-conformance with the safety requirement. Where a potential safety hazard is identified, please indicate this in the “Comments” column.
Please contact the InPlace Care office immediately to discuss any non-conformances. The Clinical Manager is to determine whether services to the client may proceed, and/or what corrective action is required to manage the safety risk.
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Home Safety Checklist | Yes | No | ||||
Smoke alarms are installed and functioning | ||||||
Any hazardous materials/chemicals are stored safely | ||||||
The client agrees the worker will only use InPlace Care recommended cleaning products | ||||||
Dog/s will be restrained (tied up) whilst the worker is present | ||||||
No lifted or torn floor coverings that present a tripping hazard are present | ||||||
Lighting is appropriate | ||||||
Ventilation and heating/cooling is adequate | ||||||
Entry/exit to and from the premises is unrestricted | ||||||
Driveways, paths and outdoor steps (if applicable) are in good order | ||||||
Adequate supply of power points to negate the need for extension | ||||||
Adequate hand-washing facilities and toilet facilities are available | ||||||
No major pest infestation on the premises is present | ||||||
Grab rails are installed (if required for mobility/transfer) | ||||||
Manual Handling and equipment is in good working order and accessible | ||||||
I feel that this is a safe working environment | ||||||
There is a care plan in place that reflects the clients service and health status | ||||||
Details of any other Identified Safety Hazards |
Risk Management Plan | |||
| Client’s Signed Agreement | Date | |
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