Health & Safety Policy Creater
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What is the name of the main contractor?
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This should be the name of the Franchisee or the main person in the business.
This is a required question
What are you trading as?
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What part of Select do you belong to?
SelectCleaning
SelectLawnMowing
SelectValet
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What is your address?
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This should be your office address if you have one or your home address if you do not have an office. DO NOT use the Select office address
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What is your mobile phone number?
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If you do not have a mobile enter your home phone number
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List your employees (if you have any) & their mobile numbers
List in this format: John Smith, 021 123 456, Paul Brown, 0275 678 789 and so forth.
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Have you completed the Select Training?
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You should not be doing this policy until you have completed the training. If you have not completed training stop completing this form and come back to it when you have finished your training.
Yes
No
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Do you have your own Health & Safety Policy?
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You are creating your policy now, so answer yes.
Yes
No
This is a required question
Have you checked all of your equipment etc yearly?
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if you have only just started with Select then answer no
Yes
No - I have only just started by Select business
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Are you committed to taking all reasonable and practical steps to make sure that: 1. What work or associated tasks that you have been engaged to do will be carried out in a safe and healthy way; and 2. That your trade tools, machines and equipment, including safety gear and clothing, are in good condition, & in using them they do not harm you or any other person who may be working in close vicinity to you; and 3. Where & how you carry out your work/tasks does not harm yourself or any other person as a result of your not controlling hazards that may arise out of your work/tasks, practices and/or work areas/workplaces
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Yes
No
This is a required question
Do you understand that the person or company that engaged you to carry out the agreed contractual work is the PRINCIPAL (who may be represented by their site manager/foreman) & if they operate a business where you are working, they are to provide all information about their health & safety policy & procedures, on-site hazards & their controls, accident/incident reporting, recording & investigation, site emergency responses & inspection & monitoring activities to enable expected performances?
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Yes - I understand
No - I do not understand
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Choose the personal protective equipment you need in your business.
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Choose as many items as are relevant. If need be add any extra items under "Other". If more than one seperate the items with a ,
Protective gloves
Closed footwear
Closed footwear with steel caps
Safety glasses / eye protection
RCD safety switch
First aid kit
Hearing protection
Overalls
Sunscreen
Sun hat
Shin protection
Other:
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Which of the following best describes the work you will be doing?
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Choose which type of work you do. If need be add extra items to the "Others" field seperated by a ,
To provide cleaning services as per specifications and schedules agreed with customers.
To provide lawn mowing and general gardening services as per specifications and schedules agreed with customers.
To provide vehicle grooming services as per specifications and schedules agreed with customers.
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If you are a SelectCleaning Franchisee list all the machinary, tools, appliances, materials, chemicals & substances etc to be used in the work you do.
Choose as many items as are needed for your particular work. Add any extras in the "Other" field with each item seperates by a ,
Vacuum cleaner
Floor polisher
Carpet cleaning machine
Steam mop
Window cleaning machine
General spray & wipe chemical
Glass cleaning chemical
Heavy duty cleaning chemical
Floor cleaning chemical
Bathroom cleaning chemical
Toilet cleaning chemical
Shower cleaning chemical
Water spot removing chemical
Cream scourer type chemical
Oven cleaning chemical
Bleach
Cleaning cloths
Scouring pads
Dusters
Toothbrush
Whisk brush
Plug hole brush
Broom
Buckets
Window cleaning squeegee
Scrubbing brush
Toilet cleaning brush
Spray bottles
Protective gloves
Heavy duty gloves
Cleaning apron
Other:
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If you are a SelectLawnMowing Franchisee list all the machinary, tools, appliances, materials, chemicals & substances etc to be used in your SelectLawnMowing business
Choose as many items as are needed for your business. Add any extras in the "Other" field with each item seperates by a ,
Mulching mower
Catcher mower
Ride on mower
Edge trimmer
Blower
Hedge trimmer
Chainsaw
Pruning saw
Sprayer
Weed killer
Oil for mowers
Petrol
Diesel
Work Gloves
Protective boots/shoes
File for sharpening blades
Shin protection
Sun hat
Sacks or bin for clippings
Ear muffs
Assorted tools
Other:
This is a required question
If you are a SelectValet Franchisee list all the machinary, tools, appliances, materials, chemicals & substances etc to be used in your SelectValet business
Choose as many items as are needed for your business. Add any extras in the "Other" field with each item seperates by a ,
SelectValet Cutting compound
SelectValet Polish Crème
SelectValet Detail spray
SelectValet Detailer’s carnauba wax
SelectValet Cutter Wax
SelectValet Glass Polish
SelectValet Odour Eliminator
SelectValet Extreme Wash – Heavy Duty Wash
SelectValet Gloss Work – Car Wash
SelectValet SelectWaterless Chemical
SelectValet Leather Cleaner
SelectValet Bug remover
SelectValet Glue & Tar remover
SelectValet Tyre Shine
SelectValet Metal Polish
SelectValet Tyre and Bumper Gel
SelectValet Meguiars PlastX Clear plasic polish
SelectValet Leather conditioner creme
SelectValet Interior Protectants
SelectValet Plastic Cleaner
SelectValet All Purpose Cleaner
SelectValet Fabric Cleaner
SelectValet Glass Cleaner
Interior Exterior Detail Can
Fresh Linen Odor Kill
Assorted chemical applicators
Microfibre cloths
Spray Bottles & Triggers
Plastic scrapper blades
Polishing pads
Polishing machine
Safe Scrub Pad (Yellow)
Assorted brushes
Gloves
Petrol or diesel for generator
Generator
Water blaster
Assorted storage boxes
Canopy
RCD switch
Extension cords
Step ladder
Safety glasses
Sunscreen
Hearing protection
Sun hat
Sunscreen
Razor blade with holder
Hose with spray gun
Clay Bar
Vacuum Machine
Plastic Bags
Other:
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Which of the following are accurate for your business?
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Choose as many as needed.
If provided by the Principal I will make sure I know & perform/react according to the Principals emergency site plan & instructions
I will negotiate & agree on an appropriate & practicable response plan with Principal when working alone and / or in isolation
I will be aware of basic first aid & carry my own 1st aid kit
When working on my own I will carry an operational mobile phone at all times
I will ensure some other person has a copy of my daily schedule & an expected return time
I will have in place a proceedure for someone to contact emergency services if I do not return by a given time
Other:
Sorry - you have missed some items. Please check again.
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Meetings & Inspections.
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I will.......(Choose the items that are accurate for your business.)
Attend participate in any planned Safety Meetings as when requested
Carry out Equipment & Workplace Conditions Inspections regularly & record results
Report Substandard conditions acts to site Controller/Principal
Sorry - you have missed some items. Please check again.
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Accident Reporting, Recording & Investigation.
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Choose the items that are accurate for your business.
Keep an accident / incident register
Record all accidents & incidents (including near misses) in my own register & maintain the register.
Immediately report any serious harm accident, or potential serious harm situations, to Principal or the appropriate authorities
Not tamper with an accident scene until cleared by an OSH inspector
Investigate the accident & send the prescribed notification form to the appropriate government authority within 7 days of the accident happening
Other:
You have missed some items - please check again
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Hazards & Controls
Below are some common hazards - choose as many as you think may happen on your work.
TASK: Vacuuming. HAZARD: Electric shock, tripping over cords, knocking other items. HAZARD CONTROL: Pay attention while working, anticipate where you will be moving, have all electrical items checked yearly, use rcd switches, place cords out of work path
TASK: Dusting. HAZARD: Contact with electricity, knocking things over. HAZARD CONTROL: Pay attention while working, do not wet dust around electrical points, check what your duster will be coming into contact with
TASK: Floor Washing HAZARD: Slippery floors, electrical shocks, machines out of control. HAZARD CONTROL: Pay attention while working, have all electrical items checked yearly, use rcd switches, make sure machines are switched off b4 turning power on, wear appropriate footwear
TASK: Window Cleaning HAZARD: Heights. HAZARD CONTROL: Use ladders correctly, watch for power lines, work close to your body.
TASK: Mixing Chemicals. HAZARD: Spillage / splashing, mixing to wrong strength, mixing 2 incompatible chemicals. HAZARD CONTROL: Use gloves & safety glasses when mixing chemicals, always put water in bottles first, double check mixing ratios, do not mix 2 chemicals in same container
TASK: Trimming edges. HAZARD: Line from trimmers, flying objects, tripping, noise, spilling fuel. HAZARD CONTROL: Pay attention while working, anticipate where you will be moving, Wear safety shoes, goggles & ear protection, watch the surface you are working on for loose objects that may go through machine. Remove object to a safe place, watch where you are walking – ensure you do not trip and lose control
TASK: Mowing. HAZARD: Mower blade, flying objects, tripping, noise, spilling fuel. HAZARD CONTROL: Never put any part of the boby near the moving parts of the machine while it is in operation or stopped, wear safety shoes, goggles & ear protection, watch the surface you are working on for loose objects that may go through machine. Remove object to a safe place, watch where you are walking – ensure you do not trip and lose control
TASK: Blowing leaves. HAZARD: Moving parts, items that have been blown, tripping, noise, spilling fuel. HAZARD CONTROL: Never put any part of the boby near the moving parts of the machine while it is in operation or stopped, wear safety shoes, goggles & ear protection, watch the surface you are working on for loose objects that may go be blown out- remove object to a safe place, watch where you are walking – ensure you do not trip and lose control
TASK: Pouring petrol / diesel. HAZARD: Spillage, fire, fumes. HAZARD CONTROL: Always use a funnel with fuel. Do not spill onto a hot engine. Wear eye protection when pouring. Do not stand too close to fuel
TASK: Using chemicals HAZARD: Fumes, skin contact. HAZARD CONTROL: Do not allow spray drift to be breathed in, wear eye protection & hand protection, do not spray onto body
TASK: Operating machinary HAZARD: Getting clothing caught, getting body parts caught. HAZARD CONTROL: Use machines only for the purpose intended, keep loose clothing away from machines, wear protective clothing where appropriate – specifically eye & hearing protection & hand & feet protection
TASK: Ladder work. HAZARD: Falling off, hitting power lines HAZARD CONTROL: Use ladders correctly, watch for power lines, work close to your body, use a ladder appropriate to the height you will be working at
TASK: Stress & fatigue. HAZARD: making poor decisions because too tired or under stress HAZARD CONTROL: Take regular breaks away from work area, be prepared to take time to make decisions, count to 10 before reacting when under stress
Other:
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Email Address
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Enter the email address that we will send your Health & Safety Ploicy to
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Ms Word Document (.docx)
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