Work Placement: Induction Checklist
Placement Details:
Student Name:
Job Title:
Company Name:
Supervisor Name:
On your first day at work make sure that you have answered all the questions
and ask your supervisor to check your answers. You & your supervisor
should then sign the form. Your visiting teacher will want to see this form.
Questions from Supervisor
Checked
 What must you do if you are ever late for work?

What does the fire alarm sound like?

Where are the nearest fire exits to your work area?

Where should you go if you have to evacuate the building in an emergency?

Should you attempt to use a fire extinguisher if you spotted a fire in your work area?

Where is the first aid equipment kept?

Who could give you first aid at work?

Where is the accident book kept?

To whom should you report an accident?

Should you report a minor accident or a near miss?

Are there any Health & Safety signs in your work area? Do you know
what they mean?
(Make a list on the back of this form of all the signs in your work area
and their meaning).

Are there any areas you are not allowed to go in? If so, where must
you not go?

Is there any equipment you are not allowed to use? What equipment
can you use?

Where can you wash or go to the toilet?

Are there any risks to your Health &Safety at work? What must you do about them?
Student
Signed:
Date:
Supervisor
Signed:
Date: