SITE SPECIFIC SAFETY
ORIENTATION CHECKLIST
PART 2. COMPLETE ALL SECTIONS ONCE PART 1: NEW WORKER HEALTH
AND SAEFTY ONLINE ORIENTATION HAS BEEN COMPLETED.
Name of Worker:
Job Title: Department:
Start Date at Location: Date of Safety Orientation:
Name of Direct Supervisor/Manager: Name of Orientation Provider:
Reason for Orientation:
HEALTH
& SAFETY
TOPIC YES
a NAME AND CONTACT INFORMATION FOR SUPERVISOR
I have been advised of my Supervisor’s name and contact information.
b JOINT OCCUPATIONAL HEALTH AND SAFETY COMMITTEE ( JOHS COMMITTEE)
I have been advised on how to contact the committee, and have been made aware of a local worker representative on the
committee. https://my.selkirk.ca/sta/dept/safety/jointoccupationalhealthsafetycommittee/
c WORKPLACE HEALTH AND SAFETY RULES
I have been trained on the specic workplace safety rules related to my work/work area.
d WORKER’S RIGHTS AND RESPONSIBILITIES
I have been advised on my rights and responsibilities as a worker.
e POTENTIAL HAZARDS OF A WORKPLACE
I have been advised about the hazards that may be encountered while performing my work tasks.
f PERSONAL PROTECTIVE EQUIPMENT (PPE) (IF APPLICABLE)
I have received the appropriate orientation and training in the use and care of any PPE or clothing that is required to safely
perform my work. Required PPE has been provided.
g EMERGENCY PROCEDURES
I have been advised of the emergencies that could occur and the procedures to follow.
h FIRST AID
I know the number for rst aid at my campus.
i ACCIDENT INCIDENT REPORTING AND INVESTIGATION
I am aware of the incident reporting procedures.
j VIOLENCE IN THE WORKPLACE
I have been advised of any potential risk for violence in the workplace.
k WORKING ALONE OR IN ISOLATION (IF APPLICABLE)
I have been trained on the policies and procedures to be followed for working alone or in isolation.
Notes:
New Hire Restart after Absence Change of job within Selkirk College or Relocation to new workplace
Within Reach. Beyond Imagination. 1 888 953 1133 selkirk.ca
SITE SPECIFIC SAFETY
ORIENTATION CHECKLIST
PART 2. COMPLETE ALL SECTIONS ONCE PART 1: NEW WORKER HEALTH
AND SAEFTY ONLINE ORIENTATION HAS BEEN COMPLETED.
HEALTH
& SAFETY
Health and Safety oers a number of safety related courses to supplement the New Worker Safety Orientation.
Courses can be created for departments at request.
The information detailed in section 2-3 and corresponding education and training was provided to the worker.
Documented training records should be retained for all Selkirk workers to show due diligence.
These documents are generally retained in the employee le in HR or by the supervisor
TRAINING COURSES YES No DATE COMPLETED
MANDATORY
New Worker Safety Orientation
Respect in the Workplace
Safety Supervision at Selkirk (only for supervisors)
RECOMMENDED
Fire Warden Training Course
PROGRAM SPECIFIC
Occupational First Aid Level 1
Occupational First Aid Level 3
OTHER COURSES
New worker Name Date Signature
Orientation Provider Name Date Signature
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