New Employee Safety Orientation & Training Checklist Template printable pdf download

NEW EMPLOYEE SAFETY ORIENTATION

& TRAINING CHECKLIST

Full-Time Employees: Supervisors and/or Safety Committee Coordinator to review with new hire. Completed form

to be sent to HR department for further processing and training assignments within one week of new hire start date.

Part-Time Employees: Supervisors and/or Safety Committee Coordinator to fill out and review with new hires,

forward to Payroll for further processing and training assignments.

Employee Name: _____________________________________ Job Title: _____________________________

E-mail: ______________________________________________ RED ID #: ___________________________

Supervisor’s Name: ___________________________________ Department: ___________________________

Safety Orientation Topics

Injury & Illness Prevention Program

General Safety Information

 Discussed “Report of Unsafe Condition or Hazard”

 Location of Safety Postings

 Location of Automatic External Defibrillator

Form

 Employee has received and signed “Code of Safe

(A.E.D.)

Practices”

 Ergonomic Work Station

 Reporting of Work-Related Injuries

o Overview of RMIs (Repetitive Motion

 Safety Committee – Area coordinator, roles,

Injuries

o Proper Lifting

responsibilities, etc.

 SDS Data Sheets and Information

o Safe work practices

 Chemical Safety & Personal Protective Equipment

o Workstation evaluations

 Location of IIPP

 Uniforms & Attire

o Discuss appropriate attire

Fire Safety, Emergency & Disaster Preparedness

o Discuss appropriate footwear

 Designated evacuation assembly points

 Driving Safety (if applicable)

 Emergency Action Plan

- Enroll in DMV Pull Program

 Emergency escape routes

 Yes

 List of emergency phone numbers

 No

 Types of fires

 Types of fire extinguishers

 Other__________________________

 Location of fire alarms

 Other__________________________

 Locations and use of fire extinguishers

Certifications Required* (if

Mandatory Trainings* (Training modules to be assigned by area department

applicable)

and/or HR department based on items marked below.)

 Sexual Harassment