The Job Safety Assessment Form is a fundamental tool in New Zealand's workplace health and safety framework, designed to meet obligations under the Health and Safety at Work Act 2015 and associated regulations. This document should be completed before commencing any new task, when procedures change, or when reviewing existing work processes. It provides a systematic method for identifying potential hazards, assessing their risks, and implementing appropriate control measures. The form serves as both a risk management tool and a legal record, demonstrating due diligence in maintaining workplace safety. It is particularly crucial for high-risk activities and industries where worker safety is paramount, and it helps organizations maintain compliance with New Zealand's strict workplace safety requirements.
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1. Job/Task Details: Basic information about the job/task being assessed, including location, date, and description of work
2. Assessment Team: Details of personnel conducting the assessment, including names, roles, and contact information
3. Hazard Identification: Systematic listing of all potential hazards associated with the task
4. Risk Assessment: Evaluation of identified risks using likelihood and consequence matrix
5. Control Measures: Detailed description of required controls following the hierarchy of controls
6. Personal Protective Equipment: Specific PPE requirements for the task
7. Emergency Procedures: Emergency response procedures specific to the identified hazards
8. Authorisation and Sign-off: Approval section for relevant supervisors and workers
1. Environmental Impact Assessment: Required when work may affect the environment or when working with hazardous substances
2. Permit Requirements: Include when specific work permits are needed (e.g., confined space, hot work, working at heights)
3. Special Equipment Requirements: Required when task involves specialized equipment or machinery
4. Contractor Management: Include when contractors are involved in the task
5. Site-Specific Requirements: Add when there are particular site conditions or rules that need to be considered
6. Change Management: Include when assessment needs to account for potential changes in conditions or scope
1. Risk Assessment Matrix: Standard risk assessment matrix used for evaluating hazard risks
2. Hazard Checklist: Comprehensive checklist of common workplace hazards
3. PPE Selection Guide: Guide for selecting appropriate personal protective equipment
4. Emergency Contact List: List of emergency contacts and procedures
5. Safe Work Method Statement Template: Detailed step-by-step procedure template for high-risk activities
6. Incident Report Form: Template for reporting any incidents or near-misses during task execution
Relevant legal definitions
Clauses
Relevant Industries
Construction
Manufacturing
Mining
Agriculture
Transportation
Warehousing
Energy and Utilities
Healthcare
Forestry
Marine Operations
Chemical Processing
Waste Management
Infrastructure
Telecommunications
Relevant Teams
Health and Safety
Operations
Production
Maintenance
Quality Assurance
Engineering
Field Operations
Risk Management
Compliance
Project Management
Facilities Management
Technical Services
Environmental Management
Relevant Roles
Health and Safety Manager
Safety Coordinator
Site Supervisor
Project Manager
Operations Manager
Risk Assessment Specialist
Compliance Officer
Construction Manager
Factory Supervisor
Maintenance Manager
Production Manager
Quality Control Manager
Field Operations Supervisor
Engineering Manager
Environmental Health and Safety Specialist
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