All workers should perform a hazard assessment at the work site BEFORE WORK BEGINS. This
assessment helps you to identify how you might be exposed to COVID-19 at the work site and how you
can protect yourself.
The COVID-19 virus is highly contagious. Your employer must put safety measures in place and provide
training about the safe work practices that will protect you. Everyone must follow Public Health Order(s)
for the region you are working in.
See WSCC’s web page with COVID-19 Resources for more information.
Worker Name:
Supervisor Name:
Work Site:
If you cannot answer all of these questions, speak with your supervisor before starting work.
Evaluate your workspace and tasks for the day, and ask:
Do you know how to report possible exposure to COVID-19 at work?
Do you know what work tasks put you at risk of being exposed to COVID-19?
Do the safe work practices at your work site reduce your risk of being exposed to COVID-19?
Are you required to wear specific PPE? If yes, have you be trained to safely use and take care of
the equipment?
Do you know when and how often you need to wash your hands or use hand sanitizer?
Do you know if there is a process and schedule for disinfecting work areas and tools?
Are there situations where the safe work practices might not be fully effective? If yes, how will you protect yourself?
I have reviewed and understand my employer’s Workplace Risk Assessment for my workplace.
Date reviewed:
Are there any additional risks of exposure and/or ideas for safety measures that you should discuss with your
Keep a copy for your records and provide a copy to your supervisor.
Review this form regularly.
If the hazards or conditions change at the work site or in your community, you should review and update this