Welfare Checks Form Ragnar SecurityOfficer's Full Name(Required) First Last SIA License Number 1(Required) SIA License Number 2 Site Name(Required) Choose one site where officer is deployedTime Hours : Minutes Date DD slash MM slash YYYY Visit/Telephone(Required)VisitSelect:TelephoneOfficer imageMax. file size: 256 MB.Has the Officer received training/induction appropriate to the role(Required)YesSelect:NoComment Does the Officer understands Site Emergency Procedures and what they are?(Required)YesSelect:NoComment Does the Officer have site appropriate uniform?(Required)YesSelect:NoComment Has PPE been issued (where appropriate)?(Required)YesNoSelect:Not requiredComment Are regular breaks taken?(Required)YesSelect:NoPlease confirm your break durationsComment Any Health and Safety issues?(Required)SelectYesNoComment Any Welfare issues (work or personal)(Required)YesSelect:NoWelfare Discussion & Health and Safety Concerns – record as much information as possible Childcare Medical Harrasment/Bullying Working Hours Marital Issues H & S Concerns Other CommentSend me a copy of my responses(Required) Yes No Officer SignatureOffice Use OnlyGeneral Comments:(Required) Corrective action to be taken:(Required)NoSelect:YesIf Yes – Corrective action to be taken: Interviewing manager First Last Position:Ops Support ManagerSelect:Senior Ops ManagerDirectorSignature(Required)HiddenFollow up
