Hand S
Hand S
Write down the name or names of the people you consulted with to complete this
questionnaire:
6. Are there regular health and safety meetings? If yes, when are these
meetings held? /1K
8. What are the potential hazards of this co-op position and in this
workplace? (i.e. noise level, chemicals, etc.) /1T
9. What Health and Safety training will your employer provide and when?
/1K
14. What is the procedure to follow if there is a fire or other emergency? /3K
15. The school and company procedures I must follow if I am injured at the
placement are (list the steps in order): /3K
16. Who is trained in first aid, CPR, etc. in my work area? /1K
17. Where are the safety memos posted at your placement? /1K
Jean Vanier Cooperative Education
DIAGRAMS
1. Create and describe your route from your work area to your closest fire
exit in case of a fire or an emergency. (Draw a floor plan on a separate
sheet) /5C
2. Locate the eye wash station. Inquire when you must use the eye wash
station. Write this information below. (Indicate the eye wash station on
your floor plan) /2K
A. State three types of accidents that could happen at your co-op placement.
/3T
1. ___________________________________________________________
__________________________________________________
__________________________________________________
2. ___________________________________________________________
__________________________________________________
__________________________________________________
Jean Vanier Cooperative Education
3. __________________________________________________
__________________________________________________
__________________________________________________
B. Referring to the previous question, state two reasons why these accidents
may happen. /3T
1. __________________________________________________
__________________________________________________
__________________________________________________
2. __________________________________________________
__________________________________________________
__________________________________________________
C. List three safety points to keep in mind at your co-op placement? /3T
1. __________________________________________________
__________________________________________________
__________________________________________________
2. __________________________________________________
__________________________________________________
__________________________________________________
3. __________________________________________________
__________________________________________________
__________________________________________________
D. What precautions (i.e. PPE, proper chair, etc.) are you taking to ensure
your personal safety at the co-op placement? /3T
1. __________________________________________________
__________________________________________________
__________________________________________________
Jean Vanier Cooperative Education
2. __________________________________________________
__________________________________________________
__________________________________________________
3. __________________________________________________
__________________________________________________
__________________________________________________