Microsoft Word - 14-B Daily Supervisor Heat Illness Prevention Checklist.docx
Daily Supervisor Heat Illness Prevention Checklist
Job Site: ______________________________________________ Today’s Date: __________________
| YES | NO | |
|---|---|---|
| 1. Has the designated person received HIP training? | □ | □ |
| 2. Do you have a readily available copy of Therma’s HIPP (may be written or electronic)? | □ | □ |
| 3. Have you reviewed the HIP with your employees? | □ | □ |
| 4. *Have you evaluated the weather and determined to the possibility of high heat potential (+95 degrees)? | □ | □ |
| 5. Do you have provisions for accessible, adequate (1 qt. per hr. per employee), fresh/cool water for your employees? | □ | □ |
| 6. Have you encouraged your employees to drink water frequently, especially, during high heat? | □ | □ |
| 7. Have you provided your employees with access to shade? | □ | □ |
| 8. Have you encouraged your employees to take “cool down” breaks (min 5 minutes) if they feel they need to protect themselves from overheating? | □ | □ |
| 9. Have you determined an effective method to contact emergency services if they are needed? | □ | □ |
| *High Heat Procedures (+95 degrees) | ||
| 10. Is it possible to reschedule outdoor activities during non-high heat hours? | □ | □ |
| 11. Do you and your employees have an effective method to communicate during the work shift? | □ | □ |
| 12. Have they been encouraged to contact you if needed? | □ | □ |
| 13. Do you have a method to actively monitor temperature (e.g. dry bulb thermometer) throughout the work shift? | □ | □ |
| 14. Can you effectively observe your employees during the work shift? If not, have you implemented a “buddy system”? | □ | □ |
| 15. Do you have newly assigned employees that will be closely monitored / work modified for the first 14 days of work? | □ | □ |
| 16. Have you conducted a daily training briefing (prior to work) which covers weather forecast, frequent drinking of water, access to shade, signs/symptoms/treatment of heat illness, cool down breaks, communication, and contacting emergency services? | □ | □ |
| 17. Have you designated a trained employee as the person responsible for responding to and providing treatment until emergency services arrive? | □ | □ |
Daily Supervisor Heat Illness Prevention Checklist
Job Site: __________________________________________ Today’s Date: _______________
| Crew Signatures | Print Name |
|---|---|