Risk Assessment
Mayo Injury Management Service values your Health & Safety.
Have you checked the following before your first new home visit / worksite visit?
Clients Surname: «ClientLastName»
First Name: «ClientFirstName»
Date completed: ………………………………………………………..
Yes
No
Comments
The location of residence/workplace?
Issues of access availability? Any environmental
issues that can be identified?
Emergency or Disaster plan in place and evacuation
plan if required? What is it?
Determined if there is safe parking available?
Ensured that any animals are restricted?
Obtained details if other persons may be present and
their relationship to the client?
Does the person require a chaperone/ support
person and who will that be?
Determined if there are any concerns that the client
and/or others who may be present maybe
aggressive, violent or have behavioural issues worth
noting? Any known triggers for any behavioural
issues?
Are there any identified issues concerning domestic
violence and/or Apprehended Violence Orders
(AVOs)?
Asked if any firearms are stored on the property? Are
they licensed?
Determined if there is mobile phone reception at the
location?
Home visit to proceed and any recommendations.
Any communication deficits or language
requirements identified and how managed? Preferred
method of communication ongoing i.e.
phone/email/text/mail
Any cultural or religious considerations required for
assessment and ongoing intervention?
Home visit safety procedure involves ensuring outlook calendars are up to date with participants name and
expected time required, inclusive of travel time for visit, manager and/or admin supervisor to contact therapist if
they have not returned back to the office in the expected time frame. If not returning back to the office due to an
end of day appointment a text message and/or phone call to the manager or admin supervisor is required. If your
own safety becomes a concern at anytime during the appointment excuse yourself and leave the premises.
Advise manager and/or admin supervisor if this is required and the incident that occurred.