Health, Safety and Wellbeing Report for SLT Report

Checking authorization...

This form is for use by the Health and Safety Officers for the local office.

Thank you! Your safety report has been submitted successfully.

There was an error submitting your report. Please try again.

You are viewing this form as a manager. The form is read-only for your reference. Only Health and Safety Officers can complete and submit this form.

This form is for the office managers to complete one week prior to the relevant SMT meeting. Please complete these with any incidents since your last report.

Office this report applies to *

Were there any hazard incidents since the last report *

If none, type "No incidents"

Current hazards that require attention *

List all hazards that require attention.

Earthquakes *

List any earthquakes that required taking shelter or evacuating the premises. If none, type "No incidents"

Do you feel that all staff are currently aware of earthquake procedures while on the premises * Please Select Yes No

Fire drills performed since last report *

Include any outcomes and learnings from the fire drills

Date of next fire drill, if known

Medical Emergencies *

Detail any medical emergencies that occurred on premise or to staff while working remotely. If none, type "No incidents".

Do you feel that supplies on premise are adequate to deal with emergencies that do not require an ambulance * Please Select Yes No

Please tell us more on what you need to deal with medical emergencies

Detail any floods or extreme weather since the last report *

Please indicate any floods or extreme weather that could have posed a safety risk to staff. If none, type "No incidents".

Detail any bomb threats / serious harm events *

Please indicate any events that could have resulted in serious harm to staff through violence or implied violence. If none, type "No incidents".

Are you confident you know who to contact in the event of an emergency? * Please Select Yes No

The Emergency Response Plan is available here: Emergency Response Plans. The Call Tree is available to managers who know how to access it.

Does at least one person in the office hold a current First Aid certificate * Please Select Yes No

Submit Notify all H&S Officers to complete form