JOB SAFETY ANALYSIS WORKSHEET (JSA)

Activity: Window Cleaning / Client Contact:
(Name and phone number)
Workplace:
(Name of building, location within the building and address) / Client Purchase Order Number:
(If applicable) / JSA No:
Date JSA Prepared: /

Date work is to be performed:

Names of all proposed employees:
JSA prepared by: /
Authorized by:

Company Name:

Address:

ABN:

Tasks
List the tasks performed during this assessment / Hazards
Against each task list the hazards that could cause injury when the task is performed. / RB / Risk Control Measures
List the control measures required to eliminate or minimise the risk of injury arising from the identified hazard. / RA / Responsible
Officer /
/ NOTE: RB = Risk Rating before controls implemented - RA = Risk Rating after controls are implemented /
Possible electrocution / 2E / Operator to check machinery prior to use for any possible damage. Check that the test and tag is current / 5E / Operator to ensure this is done
Damage to environment / 3D / Operator to dispose of waste appropriately off-site. / 5D / Operator to ensure this is done
Slip and fall / 3C / Operators to ensure signage/barricades are used and that all areas are safe when the job is finished. / 5C / Operator to ensure this is done
Trips caused by exposed hoses/cords / 3C / Operators to ensure signage/barricades are used and extra care is taken including how the hoses/cords are laid out. / 5C / Operator to ensure this is done
Exposure to chemicals / 3C / Always use non-hazardous chemicals if possible. If hazardous products have to be used, then the operator is use as outlined in the MSDS plus ensure current MSDS including risk assessments for hazardous chemicals and a hazardous substance register is also available on site at all times. PPE is to be available and used on site. / 5C / Operator to ensure this is done
Damage to self and or client property / 3C / Operator to ensure work is organised through client to ensure furniture is moved. Otherwise all furniture is to be moved as per the manual handling procedure dictates. / 5C / Operator to ensure this is done
Manual handling injuries / 3C / Operator to ensure machinery and or property is handled according to the relevant manual handling procedures. Regular breaks may be necessary of longer jobs. / 5C / Operator to ensure this is done

Checked by: Operator

Method of classify risk

Reference: Workplace Health and Safety - Risk assessment -

Risk Management Code of Practice

Step 1 Determine Likelihood – What is the possibility of the event happening?

/
Criteria
/
Description
Almost certain / Over Straining / On Jobs over 2,000 Meters
Likely / Tripping over hoses / Have offsider pull hoses out of way
Possible / Operating too close to People working / Place out of area from work way
Unlikely / Could occur at some time / Event is not likely to occur at the site or I have not heard of it happening
Rare / May occur only in exceptional circumstances / Event is practically impossible.

Step 2 Determine Consequence - What will be the result if it happens?

Classification
/
Example detail description
Insignificant / Bruise
Minor / Small Cut
Moderate / Have First Aid Officer Treat
Major / Have worker Go home
Catastrophic / Need Ambulance

Step 3 Determine the risk score

CONSEQUENCE
LIKELIHOOD / Insignificant (A) / Minor (B) / Moderate (C) / Major (D) / Catastrophic (E)
Almost certain (1) / 1A / 1B / 1C / 1D / 1E
Likely
(2) / 2A / 2B / 2C / 2D / 2E
Possible
(3) / 3A / 3B / 3C / 3D / 3E
Unlikely
(4) / 4A / 4B / 4C / 4D / 4E
Rare
(5) / 5A / 5B / 5C / 5D / 5E

Step 4 Record risk score on worksheet (Note – Risk scores have no absolute value and should only be used for comparison and to engender discussion

RATING / ACTION
Significant / ACT NOW – Urgent - do something about the risks immediately. Requires immediate attention.
Medium Significant / Highest management decision is required urgently.
Insignificant / Follow management instructions.
Acceptable / OK for now. Record and review if any equipment/ people/ materials/ work processes or procedures change.


Hazard Elimination and Risk Control

To properly manage exposure to risks, control measures must be considered for their appropriateness. It is worth remembering that change may itself introduce new risks that need to be identified, assessed, treated and monitored.

Example – if one procedure is substituted for another, do employees know of the change, do they accept the change and is it actually implemented?

Control measures should be considered and implemented in the following order (Hierarchy of Controls):

1. ELIMINATION 4. ENGINEERING CONTROLS

2. SUBSTITUTION 5. ADMINISTRATIVE MEASURES

3. ISOLATION 6. PERSONAL PROTECTIVE EQUIPMENT

1. ELIMINATION of the hazard or preventing the risk.

Examples:

a. Repairing or replacing faulty equipment

b. Eliminating dangerous work processes

2. SUBSTITUTION of the hazard with another that has a lesser risk.

Examples:

a. Use a different, less dangerous piece of equipment

b. Use safer materials or chemicals.

3. ISOLATION of the hazard that is creating risk to employees and others.

Examples:

Electrical cords taped down, Safety switches.

The use of fume cupboards is a good way of isolating dangerous chemicals from workers using them.

4. ENGINEERING CONTROLS - minimising the risk by engineering means.

Examples:

a.  Adding machine guards or lock-out devices.

b.  changing lighting to reduce glare

c.  installing exhaust fans, etc

5. ADMINISTRATIVE MEASURES – Implementing safe work practices.

Examples:

a. Establish written safe work procedures

b. Change daily routines, e.g. so that keyboard operators get breaks from keyboarding to do other duties.

6. PERSONAL PROTECTIVE EQUIPMENT – Least effective way of controlling hazards.

Note:

a.  PPE is only useful when it is in good condition and always worn correctly.

b.  People need to know when to wear their PPE and how to fit and look after it.

c.  Employers must ensure that the equipment provided is appropriate for the person and controls the

risk for the person.

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Training Register for JSA

I acknowledge that I have read the attached JSA and the controls are clearly understood. My training and qualifications are current and allow me to perform my duties whilst complying with this JSA. I have been consulted and have had the opportunity to provide input.
DATE: / NAME: / SIGNATURE:

Training facilitator:

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