Home Office Checklist - Telework Toolkit
Home Office Checklist
Use this form to plan for and document home-office setup
EMPLOYEE NAME
Employee Teleworks:
Number of Days Per Week Regularly Telework
Occasionally 1 2 3 4 5+
Security/Sensitivity of Information Employee Handles: Low
Moderate
High
In field / travels
Office Set-up
Yes
Adequate desk or work station
Comfortable & supportive office chair
Good lighting
Adequate storage
Sufficient electrical outlets
Have you performed an office safety check?
If small children are around, have you child-proofed your office?
Not
No
Required
Notes / Explanation
Computer Equipment Type of unit: No computer required Desktop Provided by: Employer Employee Approved by management: Yes No
Laptop
Notes / Explanation
Internet Connection
Type of Connection: Dial up No connection required
DSL/Cable Other
Installation paid by:
Employer Employee Other
Monthly service paid by: Employer Employee
Approved by management: Yes No
Other
Telephone
Home phone (land line) Second line Cellphone PDA VOIP Call forwarding from office Voice mail / Answering service Telephone conferencing Other: Approved by management: Yes
Employee provided
No
Employer provided
Not Required
Notes / Explanation Notes / Explanation
Telework Toolkit y Home Office Checklist
Page 1 of 2
Office Equipment
Printer Fax Scanner Answering machine Webcam Other: Approved by management:
Yes
Employee provided
No
Security
Firewall Anti-Virus VPN Encryption Other: Approved by management:
Yes
Employee provided
No
Storage
Flash Drive / Disks Other: Approved by management:
Yes
Employee provided
No
Collaboration Tools
Email (compatible with office) Instant Messenger Desktop application sharing Wiki / Social networking app. Web Conferencing Video Conferencing Other:
Approved by management: Yes
Employee provided
No
Software (write in)
Employee provided
Approved by management: Yes No
Employer provided
Employer provided
Employer provided
Employer provided
Employer provided
Not Required
Not Required
Not Required
Not Required
Not Required
Notes / Explanation Notes / Explanation Notes / Explanation Notes / Explanation
Notes / Explanation
Employee Signature
Date
Telework Toolkit y Home Office Checklist
Manager Signature
Date Page 2 of 2
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