Student Outcome
  • -Able to understand and fill in maintenance forms, risk assessment forms and incident reports.

WHS Documentation

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  • Show Me!

  • Show Me!

    Understand and Fill in Forms

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    Forms are:

    • workplace documents.
    • used to communicate with others.

    It is essential to remember the 3 C's: clear, concise, correct.

    • Clear - information must be easily understood.
    • Concise - brief and exact.
    • Correct - no false information.

    Forms

    • help workplaces collect information exactly the way they need it.
    • may look different in different workplaces.

    Examples of Workplace Forms

    • Employee Incident Reports
    • Risk Assessment Forms
    • Maintenance Request Forms

    These forms require the employee to fill in details such as:

    • the date.
    • a brief description.
  • Show Me!

    Employee Incident Report

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    An employee incident form is a form filled out by an employee following a workplace incident.

    The incident may be:

    • workplace safety.
    • a personal issue with a colleague

    Personal injury or property damage may be the result of the incident.

    The form will have a section for:

    • the employee.
    • office use only.

    An employee incident report will require:

    • date and time the form is completed.
    • employee's name and position - who?
    • incident date, time, location - when? where?
    • description of incident - what?
    • explanation of what happened - how?
    • witnesses - who saw it?

    The form must be sent to the supervisor to investigate the incident.

  • Show Me!

    Risk Assessment

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    Risk assessment refers to:

    • things that are dangerous in the workplace.
    • actions that can be taken so that accidents and injuries do not happen.

    Risk can be assessed:

    • by the likelihood of something happening.
    • by the consequence that may result.

    A Risk Assessment Form will require:

    • the date.
    • a brief description of the hazard.
    • Level of Risk - the likelihood of an accident happening.
    • Severity of Risk - the consequence to workers if an accident did happen.
  • Show Me!

    Maintenance & Repair Request Forms

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    A maintenance request form may be completed if:

    • an employee identifies faulty equipment.
    • an employee identifies a safety problem.

    Maintenance forms will have a section for:

    • the employee.
    • office use only.

    To fill in the form you need to be able to:

    • describe the problem.
    • give possible solutions.
    • make a judgement on the urgency of the problem or repair.

    Maintenance Request Forms will require:

    • date and time of request - when?
    • employee's name - who?
    • work location - where?
    • brief description - what?
    • priority - high, medium, low.

    The form must be sent to the supervisor to organise for the repair to be done.

    Remember the 3 C's when filling out forms:

    • clear
    • concise
    • correct
  • Say It

    There are 2 parts in this section.

    1. The Glossary

    The glossary lists the more difficult words related to the topic in alphabetical order. The glossary also gives the meaning for each word.

    2. Look, Cover, Write, Check!

    This activity gives you practice at remembering and writing the words from the glossary.

  • The Glossary

  • Do It: WHS Documents

    Forms help workplaces collect information exactly the way they need it. Forms may look different in different workplaces, but basically they record similar information. It is important to always remember the 3 C's - clear, concise, correct.

    Clear means that the information is easily understood.
    Concise means brief and exact.
    Correct means 'no mistakes' and 'no false information'.

    Workplace Health and Safety (WHS) Forms include:

    • Employee Incident Reports
    • Risk Assessment Forms
    • Maintenance Request Forms
    Jump to Activities
  • Do It: Employee Incident Report

    Courtney Jacobsen works as a housekeeper at the 'Green Gables' Hotel. Last Monday morning, November 1st at about 10:45, Courtney Jacobsen was working with her colleague Jacki Thompson. They were cleaning Room 16 of 'Green Gables' Hotel when Courtney slipped on the bathroom floor, bumped her arm on the basin and fell to the floor.

    Courtney suffered a bruised cheek and fractured her right wrist. She told her supervisor that shampoo was spilled on the floor and she had slipped. She also said that she remembered putting her hands in front as she fell.

    Courtney's supervisor asked her to complete an Employee Incident Form.

  • Do It: Hazard Identification

  • Do It: Maintenance/Repairs Request Form

    On December 14 Arney Hutchins is working in the back section of the kitchen and discovers that the fire sprinkler is badly damaged. He is concerned because it is the only sprinkler in the back of the kitchen so it needs to be repaired immediately. At about 2 o'clock Arney fills out a Maintenance Request Form. He then takes it to his supervisor.

Check It

Check It Quiz

Click on WHS Documentation to begin.

Additional Resources:
Risk Assessment Chart

WHS Documentation
  • Introduction
  • Show Me
  • Say It
  • Do It
  • Check It

Look, Cover, Write, Check!

Try to memorise the following word.
When you are ready, click the mouse in the textbox below and try to spell the word correctly.
  • casualty
  • description
  • employee
  • hazard identification
  • incident report
  • injury
  • maintenance
  • priority
  • repair
  • request
  • risk assessment

Employee Incident Report

Drag and drop the following notes into the correct sections.
Courtney Jacobsen
November 1st, 10:45
Room 16, 'Green Gables' Hotel
slipped on bathroom floor
bumped arm on basin
fell to the floor bruised cheek
fractured right wrist
shampoo spilled on floor
she put her hands out in front as she fell
Jacki Thompson
Employee name and position:
Courtney Jacobsen
Date and Time:
November 1st, 10:45
Location:
Room 16, 'Green Gables' Hotel
Description of Incident:
slipped on bathroom floor
bumped arm on basin
fell to the floor bruised cheek
fractured right wrist
Employee Explanation:
shampoo spilled on floor
she put her hands out in front as she fell
Names of Witnesses:
Jacki Thompson

Hazard Identification

Drag and drop to the correct places.
Fire in the Kitchen
Spills on the Floor
Fire systems should be tested regularly
Make sure equipment is cleaned and assembled correctly
Spills should be cleaned up immediately
Spills on the Floor Fire in the Kitchen Faulty Appliances
  •  
  • Signage should be used when floor is wet
  •  
  • Keep objects away from doorways and exits
  •  
  • Make sure staff wear hair nets when operating equipment

Drag and drop the correct answers to complete the form

The glass shelf is in a location where it could easily be bumped. The glasses on the shelf could fall onto an employee and break.

Date Identify hazard Level of risk
2 - 4
Severity of
risk 2 - 4
How to rectify hazard Who will
rectify
When by Review
               
Nov 19
Glass shelf in hallway holding glasses. Could be bumped. Broken glasses could cause cuts.
4
3
Move shelf to safe area behind bar.
Manager
Within a week
Nov 26
2
4 weeks
Clear exit so that staff can leave the kitchen easily.

Maintenance/Repairs Request Form

On December 14 Arney Hutchins is working in the back section of the kitchen and discovers that the fire sprinkler is badly damaged. He is concerned because it is the only sprinkler in the back of the kitchen so it needs to be repaired immediately. At about 2 o'clock Arney fills out a Maintenance Request Form. He then takes it to his supervisor.

Click on the correct facts about the maintenance problem
WHEN
Date and time of request
2pm, December 14
1 pm, Last Thursday
2pm, December 15
11am, today 14
WHO
Person reporting problem
Anabelle Hutchins
Arney
Arney Hutchins
Arney Smith
WHERE
is the problem? Work location
In the hotel lobby
In the kitchen
In the bathroom
In the restaurant
WHAT
is the problem? Description of work/repair
Broken stove
Damaged fire sprinkler
Broken chairs
Broken glass
PRIORITY
Low - within the week
Medium - in 24 hours
Next month
High - same day