HRP Consulting Group, a division of BRANY
Remote Worker Safety Checklist
The success of a remote working arrangement depends on a realistic assessment of the overall safety of an employee’s workplace. The checklist is necessary to make the employee aware of the need for a safe workplace that is conducive to productive work. The employee should read and initial the checklist below to affirm compliance regarding the designated remote work area.
___ / The work space has appropriate lighting, ventilation, and is reasonably quiet and free of distractions.___ / Safety equipment, as appropriate, is maintained at the work site such as fire extinguisher, smoke and carbon monoxide detectors. First aid supplies, evacuation plans are developed, and emergency numbers are readily available.
___ / Hallways, doorways, and corners are free from obstruction to permit movement.
___ / There are enough electrical outlets to support the required equipment. All electrical equipment is free of recognized hazards that would cause physical harm (e.g., frayed, loose or exposed wires). Electrical outlets are three-pronged (grounded).
___ / Computer equipment is connected to a surge protector and placed at a comfortable height for viewing and will be Powered-down after the work day is over. Computer equipment is on a sturdy, level, well-maintained piece of furniture with keyboard (and mouse if applicable) at a height that does not cause physical issues such as wrist strain.
___ / Phone lines, electrical cords, and extension wires are secured underneath a desk or along baseboards.
___ / All HRP documents and/or files will be properly secured to ensure the protection of confidential information.
___ / Security controls are in place, such as computer passwords, to prevent unauthorized disclosure.
___ / When employees are utilizing their own home computers, computer virus protection is current.
Please record exact location of work site: ______
I, ______, certify that my responses to the checklist are true and completed to the best of my knowledge. I understand that:
· It is my responsibility to maintain the safety of equipment and HRP materials at the work site and shall hold the company harmless for injury to others at my work location. I will report accidents or injuries immediately to management. In accordance with applicable state and federal regulations, all patient and medical records or data, shall be kept confidential. I am responsible for abiding by the policies and procedures set forth in the At Will Employee Confidentiality Non-Competition and Non-Solicitation Agreement and Computer Agreement regarding appropriate use of computers, emails, and the internet. An HRP designated representative may have access to my work area to ensure compliance with safety or security requirements. I have read and understand the Policy for Remote Workers. This document does not create an employment contract nor does it create any contractual rights or entitlements.
Employee Signature______Date ______