Template Employee Orientation Form
This Section To Be Completed By Human ResourcesDate:
New Employee / Transferred / StudentName: / Union: / Medical:
Address: / City: / Postal:
Phone: / Cell: / Other:
Birth Date: / SIN: / Care Card:
Emerg Contact: / Phone: / Relation:
Department: / Division: / Position:
DL Required:
YES NO / 5500 Kg
YES NO / Copy of Drivers Licence:
YES NO / Endorsements:
CORPORATE ORIENTATION
GENERAL – This section to be completed during the corporate orientation session Safety Program / Accident Investigations / PPE / Workplace Violence
Health and Safety Policy / First Aid / Hazard Awareness / Housekeeping
Responsibilities / Claim Process/RTW / Safety Bulletin Board / Cell Phone Use
Right to Refuse / Safety Meetings / WHMIS / Ask For Instruction
General Safety Rules / Safety Committee / Emergency / EVAC / Equipment Operation
Discipline Policy / Training / Hearing Conservation / Drivers Program
Reporting Procedures / Inspections / Ergonomics / Practice & Procedures
SUPERVISOR SECTION
To Supervisors: Please ensure that your new employee has been oriented and instructed on the required topics. Division specific orientation items can be found below in checklist form. Once the form is completed and signed by both you and your new employee, keep a copy and return the original to Human Resources. The form will then be included on the employees personnel file.
Division Orientation
This section to be completed by employee’s supervisor Facility Walkthrough / Attendance / Housekeeping / Lockout – Lock and Key
Lunch Room / Smoking / Protective Equipment / ______
Parking / Safety Committee / Working Alone / ______
Bulletin Board / First Aid / Vehicle Inspections / ______
Tool Area / Evacuation Procedure / Equipment Inspection / ______
MSDS Location / Working Alone / Safety Meetings / ______
Fire Extinguishers / Traffic Control / WCB Regulations / ______
Spill Kit / Incident Reporting / Confined Spaces / ______
Divisional Orientation (continued)
Safe Work Procedures / Equipment Operating Guidelines (Identify all procedures or guidelines reviewed)
Confined Space / ______Fall Protection / ______
Lock Out / ______
Excavations / ______
Hoisting / Lifting / ______
/ ______
The following section is to assist Supervisors in identifying the required authorization / training prior to a new employee using any equipment. All equipment orientation and training performed must be documented and returned to Human Resources.
Division Equipment Authorization and Training Identification
Identify all required training Excavator / Aerial Lift / Loader / Trailer Towing
Flat Deck (Hiab) / Vactor Truck / Hoists / Lifting Devices / Light Vehicles
Grader / Backhoe / Dump Truck / Cranes
Paving Machine / Forklift / Compressor / Roller
Skid Steer / Volvo / Power Tools / WHMIS
Confined Space / TDG / Sweeper / Dozer
Fall Protection / First Aid / Milling Machine /
Equipment Authorization and Training Is The Responsibility Of The Department
Supervisor Comments:
______
______
N/A Identified Field Partner:______Division: ______
The identified field partner is used to ensure an employee is oriented during their exposure to fieldwork. Field partners must ensure a new employee does not attempt to perform tasks they have not been authorized or trained to do so. If this is not necessary, check N/A.
I have been instructed and understand the foregoing information.
Employee Signature: ______Date:______
I have instructed the foregoing information with the above employee and believe that he or she has a reasonable understanding of the information.
Orientator’s Signature: ______Date:______
Supervisor Signature:______Date:______
DIVISION ORIENTATION MUST BE COMPLETED PRIOR TO COMMENCING WORK
Original Copy To Be Signed And Returned To Human Resources.