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Short Employee Service Assessment

This document contains a checklist for orienting short service employees within 30 days of hire. It includes sections to verify if the employee received training on company policies, safety procedures, personal protective equipment (PPE), medical screening requirements, and regulated equipment operation. The employee and supervisor must both sign confirming the employee understands the reviewed content and knows where to find additional health, safety and environmental information. Copies are distributed to management and human resources. The summary concludes in 3 sentences or less as requested.

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dennisjuntak
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778 views2 pages

Short Employee Service Assessment

This document contains a checklist for orienting short service employees within 30 days of hire. It includes sections to verify if the employee received training on company policies, safety procedures, personal protective equipment (PPE), medical screening requirements, and regulated equipment operation. The employee and supervisor must both sign confirming the employee understands the reviewed content and knows where to find additional health, safety and environmental information. Copies are distributed to management and human resources. The summary concludes in 3 sentences or less as requested.

Uploaded by

dennisjuntak
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Document No F-HSE-02

SHORT SERVICE EMPLOYEE Revision 00


ASSESSMENT ( ORIENTATION) Release Date August 14, 2011
Page 1 from 2

This Check List to be completed within 30 days from the date to a person became a Short Service Employee

Name Department / Company


Date of request Date of Employment
Status Location : Office
WorkShop Project
Location Report to
Current Job Title Experiences in current position
Last Job Title Is this employee in compliance Yes No
with drug & Alcohol Policy
Last Medical Check up Have copy Medical Checkup Yes No
record have been received by HR

SECTION I –
YES NO NA
1 Have HR & HSE policies been review?
2 Have Drug, Alcohol & Weapon Policies been review?
3 Did you receive Health, Safety & Environmental Orientation Books
4 List of Training Required
Basic First Aid Training
Basic Fire Fighting Training
Level 2 First Aid Training
Level 2 Fire Fighting Training
Basic Sea Survival Training
Helicopter Underwater Escape Training
Log out / Tag out Procedures
Confined Space
Work Permit
If yes please provide copy of related Training Certificated
Have you been informed and explained the company “Accident Report” forms
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and reviewed how to use the reports by your direct supervisor or HR?
Have you been informed to the company policy which relation to reporting
6 any “Near Misses”, and review with you the reason why you must reporting,
how to make the report ?
Have you been informed the “Observation Card” and review what the
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function of the card is and when to utilize the card?
Have you been advised the company policy relation to attend or conduct a
8 Monthly Operation & Safety Meeting, also being informed to you and how to
use the reporting forms , when to use the Safety Meeting forms?
Have you have been inform to the company / customer policy relation to
9 Working Permit Regulation, when to use, how the process and what are the
reason and function?
Have you received PPE as per company regulation?
10
2 coverall/Uniform 1 set of Safety Glasses
1 set of Safety Boot 1 set of ear plugs
1 pair of Safety helmet 1 pair of rain coat
Other Specialize PPE …………………………………….

Have you have been coaching how to use the PPE and maintenance of PPE
11
by your direct supervisor/HSE ?
Have you have been informed by your direct supervisor where you can get the
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PPE replacement and procedure of PPE replacement?
Document No F-HSE-02
SHORT SERVICE EMPLOYEE Revision 00
ASSESSMENT ( ORIENTATION) Release Date August 14, 2011
Page 2 from 2

SECTION II
YES NO NA
1 Last “Medical Screening” validity of screening

SECTION III
YES NO NA
1 Do you have been inform or trained on HSE regulation on work related:
2 Do you have been informing on HSE regulation on related work: Forklift,
Overhead Crane, that only certified personnel allow operating that equipment?

Additional comment:

I have reviewed all above points and have read the Employee Orientation Leaflet and understand all
what I have read and review. And I know where to look any additional information relation to HSE or
Operation procedures.

Supervisor name Employee / 3RD Party name

Signed Signed

Date Date

Copy to be send to: Manager / Supervisor or person whom performing the induction,
H.S.E. Manager, HRD.

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