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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your name and the names of any additional workers in the designated fields. Ensure accuracy for proper identification.
  3. Fill in the work site location and date to provide context for the assessment.
  4. Answer the yes/no questions regarding safety knowledge, such as the location of the First Aid Room and availability of a communication device. This helps assess preparedness.
  5. Indicate your personal protective equipment (PPE) status by checking off items like hard hats and safety glasses. Specify any additional PPE required for your job.
  6. Evaluate potential hazards by rating their probability and severity using the provided scale. Document any very high-risk hazards immediately.
  7. Outline corrective actions taken for identified hazards, specifying whether they are engineering controls, administrative measures, or PPE-related.
  8. Finally, ensure management approval by printing their name, signing, and dating the form before submission.

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