Site Induction Record

Project details

Inductee details

(e.g. driver licence, passport)
(to be verified by inductor)
(to be verified by inductor)
Yes
No – If no, what is your work via type:

Employer details

(i.e. who pays your wages / Type N/A if self-employed)
(if self-employed / Type N/A if you are working other company)

Induction Agenda Items

Site Induction Record

  • take reasonable care for his/ her own health and safety while on site; and
  • take reasonable care that his/ her actions do not create a danger to another worker / persons health and safety on the site; and
  • comply with any reasonable instruction given by site management representative or his/ her employer about health and safety on the site
  • Safety is everyone’s responsibility so we can all be safe at work and go home to our families
  • Emergency evacuation alerts – e.g. horn, speaker phone
  • Assembly points / evacuation routes
  • Emergency evacuation procedures
  • Where emergency evacuation information is displayed

Site Induction Record

Confirmation by inductee

Declaration by inductee

I acknowledge that I have been advised on all of the above listed items and understand the points discussed. I hereby agree to follow the site policies, procedures, rules, and special conditions outlined during the site induction or that are in place from time to time. I accept that compliance to safe work practices is a condition of my continued access to the site and also a requirement under the health and safety legislation. I will also comply with any reasonable instruction given to me by site management or their representatives.

Overview

Title
Project / Site:
Site Induction Number:
Name of worker inducted:
Address:
Contact No.:
Identification Type.:
Identification No.:
Identification Document.:
General Construction Induction Card No.:
Trade / Occupation:
Qualifications / Tickets / tdcences:
Are you an Austratdan Citizen / Resident:
Who is your employer
What is your ABN
Employer Representative:
Contact No.:
Site management personnel – informed of site managers, supervisors, representatives
Site hours of operation and security requirements
Site safety rules – taken through site safety rules
Minimum PPE required for the site – Hard hat, high-vis clothing, safety boots
WHS Management Plan – show a copy explain that it is available on site to be viewed if requested
Health & Safety Representatives / Committees – informed of who they are (if apptdcable)
Worker duties – explained each worker has a legal duty to:
First Aid – informed who First Aid officers are + location of first aid equipment / facitdties
Emergency response – informed who emergency wardens are + firefighting equipment and locations on the site
Emergency evacuation procedures – explained
Traffic management – informed of any designated parking areas + flow of traffic / trucks / mobile plant in and out of the site
Exclusion zones – informed of the requirements to follow any designated exclusion zones and not to enter those zones unless they are authorised to do so.
Mobile plant – beware of mobile plant on the site (e.g. forktdfts, excavators, cranes) and stay out their way at all times.
Scaffold safety - informed of the requirements not to tamper with scaffold under any circumstances (e.g. do not remove any scaffold parts) + follow safe working loads of the scaffold.
Site amenities – e.g. toilet, drinking water facitdties, lunchroom (if apptdcable)
Site access and exit points – informed of location
Daily sign-in / out register – informed of requirements to sign in & out each day using apptdcable register + its location
Site noticeboard – informed of location of site noticeboard and workers responsibitdty to review it daily for important updates about the site
Site no smoking potdcy – explained that no smoking is permitted whilst on the site
Site drug and alcohol potdcy – explained that no worker is allowed to be working on the site if they are under the influence of drugs or alcohol
Site violence, bullying and harassment potdcy – explained that any violence, bullying or harassment is not allowed and will not be tolerated on the site
Hazard + incident reporting process – explained of that workers must report all hazards incidents, injuries to site management personnel immediately.
Stop Work Potdcy – explained that workers are to stop work immediately if they feel unsafe and report it to site management representative.
Induction to SWMS, safety procedures / instructions relevant to work / job – worker informed that they must be inducted on their employer’s SWMS + any other apptdcable safety procedures BEFORE they start work on the site
Housekeeping – workers to maintain a clean work site (clean up after themselves daily)
Electrical safety – all electrical equipment / tools to be tested & tagged (every 3 months) + be connected to RCD when being used on site + electrical leads to be elevated on stands
Non-compliance with any site requirements / rules – informed that if found to be breaching any of the site rules or requirements may face disciplinary action including being banned from site.
I confirm that I have received, and been inducted into, the Safe Work Method Statements and any other applicable safe work procedures / instructions provided to me, by my employer.
I confirm that I have the necessary skills, training, qualifications and/or experience to carry out the work/ job on the site.
I confirm that I am able to speak, read and write English OR I have had the site induction translated / explained to me in a language that I can understand.
Inductee’s Name
Apply Date
Signature