Welfare Checks Form The purpose of staff welfare checks is to ensure employees’ well-being and safety, and to identify any issues needing support.Officer's Full Name(Required) First Last SIA License Number 1(Required) SIA License Number 2 Site Name(Required) Choose one site where officer is deployedTime Hours : Minutes Date DD slash MM slash YYYY Visit/Telephone(Required)VisitSelect:TelephoneOfficer imageMax. file size: 256 MB.Has the Officer received training/induction appropriate to the role(Required)YesSelect:NoComment Does the Officer understands Site Emergency Procedures and what they are?(Required)YesSelect:NoComment Does the Officer have site appropriate uniform?(Required)YesSelect:NoComment Has PPE been issued (where appropriate)?(Required)YesNoSelect:Not requiredComment Are regular breaks taken?(Required)YesSelect:NoPlease confirm your break durationsComment Any Health and Safety issues?(Required)SelectYesNoComment Are you happy with Welfare provision onsite?(Required)YesSelect:NoWelfare Discussion & Health and Safety Concerns – record as much information as possible Childcare Medical Harrasment/Bullying Working Hours Marital Issues H & S Concerns Other CommentSend me a copy of my responses(Required)Select:YesNoOfficer SignatureOffice Use OnlyGeneral Comments: Corrective action to be taken:NoSelect:YesIf Yes – Corrective action to be taken: Interviewing manager First Last Position:Ops Support ManagerSelect:Senior Ops ManagerDirectorSignatureHiddenFollow up
