Designated Competent Person Acknowledgement Form - stlukesonline 2025

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COMPETENT PERSON DESIGNATION. An evaluation has determined that the person named below has knowledge of the systems, equipment, conditions and procedures, proper use, inspection, manufacturers recommendations and instructions, and maintenance for the activities designated below.
By way of training and/or experience, a competent person is knowledgeable of applicable standards, is capable of identifying workplace hazards relating to the specific operation, and has the authority to correct them. Some standards add additional specific requirements which must be met by the competent person.
Core competencies examples A typist must be able to type rapidly. An administrator must be able to communicate effectively. A core competency is central to the activity at hand. It is an ability without which the person is not competent.
I acknowledge that I have been thoroughly trained and have the experience to perform duties as a competent person in the areas indicated for and I understand that I have the responsibility and authority to correct hazards and to stop work in the event of a potential hazardous or imminent danger situations.
To fill out the Competent Person Designation Form, start by providing employee and company information. Next, indicate the relevant competent person designations applicable to the employee. Finally, ensure all sections regarding credentials, training, and signatures are completed accurately.
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An OSHA competent person is defined as one who is capable of identifying existing and predictable hazards in the surroundings or working conditions which are unsanitary, hazardous, or dangerous to employees, and who has authorization to take prompt corrective measures to eliminate them [29 CFR 1926.32(f)].
While it is possible for a qualified person to be designated as a competent person, it is clearly written in the OSHA Standard that this person must meet both the qualifications of a qualified person (certified degree and relevant experience) and that of a competent person (experience identifying hazards AND

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