Career and Work Exploration Policies and Procedures



Form 241-5Work-Based Learning PlacementEmployer Health and Safety Orientation ChecklistInsert School Name,Address, Town, Sask., Postal CodePhone: (Number) Fax: (Number)email address if applicableReferenceAP 241 Work-Based Learning PlacementsRevisedSeptember 25, 2020LevelSchoolSubmit toCWEX TeacherWhenFirst Days of PlacementStudent NameSchool NameCourse NameBusiness NameThis checklist will provide you with a guideline of some Occupational Health and Safety Issues which must be reviewed with your work-placement student. The objective is to make students aware of any potential hazards or occupational health and safety issues. Are these topics covered in the student’s orientation?YesNoN/AName of immediate supervisor and Occupational Health Committee member (or health and safety representative)Worker/Supervisor rights and responsibilitiesSafe work procedures and operation of equipmentUse of Personal Protective Equipment (PPE)Identification of restricted or prohibited areas, tools, equipment, and machineryIdentification of hazards in the workplace that may affect the student. Discussion on how hazards are controlledWhat to do and who to see if the student has a safety concern.What to do when there is a fire or other emergency (ex. Evacuation procedures)Location of fire exits and fire extinguishersLocation of the first aid supplies, equipment, facilities, etc.Names of staff responsible for first aidHow to record first aid treatmentProcedures for reporting accidents and injuriesWorkplace Hazardous Materials Information System (WHMIS)Workplace policies and procedures on:HarassmentViolence PreventionWorking in IsolationSmokingLocation of other important information:Materials Safety Data Sheet (MSDS)Occupational Health Committee MinutesInstructions for safe operation of each piece of equipment Important telephone numbersOTHER (Unique to employer setting)EmployersIn completing the Health and Safety Orientation with students, please consider the following questions and determine how the student is protected. Be sure all safety concerns and potential hazards are addressed with the student at the beginning of the work placement and that the safety messages are reinforced throughout the placement. This will help provide for a safe placement experience as well as expose students to issues they may encounter in the “real world”. Thank you!EquipmentWill the student be working with hand tools, power tools, equipment, etc?Will the student be exposed to any electrical hazards?Will the student be working with anything under compression?Will the student be working close to pressure pipes or steam boilers?Human ElementDoes your company have a harassment policy?Are there any situations where student could be exposed to violence?Is there a policy on smoking?Will the student be working alone? Does this pose any safety concerns?Will the student be working shifts?Will the student be exposed to high levels of stress?Work EnvironmentWill the student be subject to heavy lifting?Will the student have to work in a cluttered workspace?Will the student work at elevation? Is there fall protection in place?Will the student be exposed to flammable, corrosive, toxic, or reactive chemicals?Is there any special safety gear the student must wear?Will the student be in proximity to trenches or confined spaces?Will the student have contact with hot materials or surfaces?Will student spend periods of time exposed to the sun?Will the student work in extreme temperature-related conditions?Will the work environment be noisy? Any needed safety equipment?Will the student be exposed to excessive dust, fumes, or gases?OtherPlease discuss any potential hazards or occupational health and safety issues with the student that are unique to your organization and indicate on the checklist. Employer’s SignatureDate ................
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