Safety Training Needs Assessment

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1 Safety Needs Assessment Form Instructions: Please review each question and either check YES or NO. If a question is checked YES you will be required to complete the training topic before initial assignment of job task. Please discuss with your supervisor and have him/her sign the form. Please review the EH&S website for registration information. Safety Needs Assessment Do you receive a paycheck from UNC Charlotte (regardless if you are a student worker or full/part time employee)? Do you operate scissor lifts, man lifts or other aerial elevating platforms? Are you an employee of the University? Do you work for maintenance, custodial, or facility operations AND disturb asbestos? Departmental Safety Checklist & New Employee Orientation (NEO) Supervisor safety hazard and safe operating procedure discussion. Accident Prevention, Investigation and Reporting Back Safety and Injury Prevention Building Emergency Evacuation Plan Fire Safety and Prevention Slips, Trips, Falls Aerial Lift Accident Reporting and Investigation Asbestos Awareness REQUIRED TRAINING: Initial REGISTRATION: Attend New Employee Orientation (NEO) sponsored by Human Resources Department or complete Skillport online modules... REGISTRATION: NEO or Skillport s. s Does your work require you to lift heavy objects or repeatedly move or carry items throughout the day? Back Safety and Injury Prevention. REGISTRATION: NEO or Skillport s J:\Safety\ap-bg\Safety \ website Content 2011\Safety Needs Assessment 2011.docx 11/2011 Page 1 of 7

2 Safety Needs Assessment Do you supervisor employees or students? Do you work with potentially infectious body fluids? Do you work in a building or have the potential to be in a building? Do you work in a laboratory with exposure to chemicals? Do you work with compressed gas cylinders? Do you work at a computer workstation for four (4) consecutive hours daily? Do you work or oversee work in manholes or other confined spaces? Do you operate university owned vehicles? Do you spend long periods of time performing the same task? Behavior-Based Safety for Supervisors Bloodborne Pathogen (BBP) Building Emergency Evacuation Chemical Hygiene Plan Compressed Gas Cylinder Computer Ergonomics Confined Space Defensive Driving Fundamentals Ergonomics in the Workplace. s. REGISTRATION: NEO and EH&S s REQUIRED TRAINING: Every 2 yrs. s REGISTRATION: Skillport and EH&S s REGISTRATION: Skillport and EH&S s J:\Safety\ap-bg\Safety \ website Content 2011\Safety Needs Assessment 2011.docx 11/2011 Page 2 of 7

3 Safety Needs Assessment Do you plug in electrical use devices? Electrical Safety Awareness Duration: 0.5 hours Are you qualified to perform low voltage electrical work? Electrical Safety Low Voltage Are you qualified to perform Medium Voltage electrical work? Electrical Safety Medium/High Voltage Do you work in or around trenches ore excavations? Excavation and Trenching Do you work at heights above six feet exposed to fall hazards? Fall Protection and Elevated Work Are you required to use a fire extinguisher in an emergency? Fire Extinguisher & 49er Online Duration: 1-2hours Are you exposed to fire safety hazards? Fire Safety and Prevention Do you operate a forklift or motorized pallet jack? Forklift (Powered Industrial Truck REQUIRED TRAINING: Every 3 yrs. Do you operate a golf cart? Golf Cart Service Vehicle & Supervisor J:\Safety\ap-bg\Safety \ website Content 2011\Safety Needs Assessment 2011.docx 11/2011 Page 3 of 7

4 Safety Needs Assessment Do you work with power tools? Do you use hazardous chemicals as part of your job? Do you handle drums or other hazardous storage materials? Do you need to dispose of hazardous chemicals or work in satellite accumulation area? Do you work in an environment with excessive noise (exposure to noise greater than 85 db over an 8-hour timeweighted average)? Hand and Power Tool Safety Hazard Communication Hazardous Materials Handling and Storage Hazardous Waste Management Hearing Conservation & 49er Online Do you work in elevated temperature environments? Heat Stress Recognition Do you work in a laboratory? Laboratory Safety Do you use ladders? Ladder Safety & Supervisor J:\Safety\ap-bg\Safety \ website Content 2011\Safety Needs Assessment 2011.docx 11/2011 Page 4 of 7

5 Safety Needs Assessment Do you use class1-4 lasers? Do you work in environments removing paint or other areas where lead could be present? Do you repair, inspect, adjust, install, service, or clean machinery or equipment? Do you work with drill press, saws or other equipment? Do you work in a moldy or mildew environment? Do you spend 2 or more consecutive in office environment? Do you wear gloves, hard hats, safety glasses, goggles, body harness, etc.? Do you work with radioactive materials? Do you work with non-ionizing radiation (lasers, microwaves, etc.)? Laser Safety Lead Awareness Lockout/Tagout Machine Guarding Mold Awareness Office Safety Personal Protective Equipment (PPE) Radiation Safety for Authorized Users Radiation Safety n-ionizing & Supervisors & 49er Online J:\Safety\ap-bg\Safety \ website Content 2011\Safety Needs Assessment 2011.docx 11/2011 Page 5 of 7

6 Safety Needs Assessment Do you work in an area where exposures of nuisance dust, silica, require respirator use? Do you erect or work on scaffolds? Do you access building and grounds? Do you do a lot of manual materials handling? Are you required to remove light bulbs, motor oil, batteries, mercury containing devices? Do you operate a university van? Do you perform welding, cutting or brazing activities Are you a supervisor? Respiratory Protection Scaffolds and Ladder Safety Slips, Trips, Falls Sprains and Strains Universal Waste Van Certification Welding and Cutting Safety Workers Compensation for Supervisors & 49er Online Duration: 2 hours & Supervisor J:\Safety\ap-bg\Safety \ website Content 2011\Safety Needs Assessment 2011.docx 11/2011 Page 6 of 7

7 Safety Needs Assessment Do you work with X-ray producing devices? Do you ship dangerous goods or dry ice? X-Ray Safety IATA/DOT (Shipment of Hazardous Materials/Dangerous Goods). Do you supervise employees? EH&S Supervisor Development Do you work with biological agents? Biosafety Do you work with select agents? Select Agent J:\Safety\ap-bg\Safety \ website Content 2011\Safety Needs Assessment 2011.docx 11/2011 Page 7 of 7

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