Implementation Monitoring

Track the implementation of control measures for workplace hazards with our Implementation Monitoring form. Ensure safety and compliance in your workplace.

Implementation Monitoring
(Complete one form per workplace area or group if required)
Ref
No
Hazard
Description
Implemented
Control
Implementation
Outcome
Brief Description of
Hazard Area after
Next Inspection
Date of
Inspection
Signature of
Supervisor/Relevan
t Personnel
1
The
entrance
gate of the
kitchen is
blocked by a
Large trolley
rack
Removing the
trolley from the
passage and
placing it in a
suitable ad safe
position.
Workers have
placed the object
is a proper place
The trolley has
been placed in a
middle of the kitchen
room which was again
a hazardous issue
22/5/2019
2
Displaced
floor made
the floor
uneven and
risky for
walking
The gap between
two carpet should
be filled by any
soft material or
hazard sign is
needed
Workers have
found all the
floor gaps and
will fill them with
soft materials
Workers have filled
only that particular
place, however there
are other places which
were not received
appropriate attention
15/6/2019
3
Emergency
Exit food is
blocked by a
dangerously
placed
metallic
Removing
the metallic objet
from the front of
the emergency
gate and placing
the object in a
safe and secured
Workers have
removed the
metallic object in
front of the
emergency gate
Workers have placed
the object in the store
room and the place is
not secured properly
18/6/2019

equipment place.
4
A large
tray is
placed over
the top of a
furniture
dangerously
beside the
boardroom
Removing the
tray from the top
of the furniture
and placing it in
a flat ground to
avoid accident
Workers have
made sure that
no other material
is hanging out
The tray was placed
properly that has zero
potentiality to cause
hazards
14/6/2019
5
The
unassembled
furniture are
placed in
scattered
way
The scattered
furniture should
be properly
assembled and
placed safely.
The workers
have assembled
the furniture to
make the
premise secure
The sharp ages were
still directed to the
outside making
potential cause of
hazard.
10/6/2019
6
Gap in
ceiling layer
is making
the ceiling
plate lose
and
dangerous
The ceiling plate
should be placed
properly so that
it could not fall
off and cause
physical harm
Workers have
restore the plate
properly
Workers have placed
only that particular
plate, however there
are other plates which
were not received
appropriate attention
12/6/2019
7
Electrical
wires are
scattered
The electrical wires
should be concealed
through using fibre
A
electrician will
be appointed to
make a covered
up wiring system
The electrical wires
have not received
proper care and
service
15/6/2019

over the
floor
dangerously
plating
8
The
signboard is
placed
bellow the
safe height
Removing the
signboard from
its position and
putting the
signboard at a
safe height
The workers
have fit the
signboard to
make the
premise secure
The sign board is
hanging in risky
position that can
cause hazard
14/6/2019
9
A broken
door is
placed on
the wall
Removing the
door from the
current place and
placing the object
in a safe and
secured place.
The workers
have removed
the furniture to
make the
premise secure
The door was placed
correctly, however,
more secured
positioning will be
required
18/6/2019
10
A metal
ladder is
placed in
front of store
room
entrance
Removing the
metal ladder from
the current place
and placing the
object in a safe
and secured
place.
The workers
have replaced
the metal ladder
to make the
premise secure
It was not placed at
the designated
secured place that is
making potential
cause of hazard.
21/6/2009

FOR THE ASSESSOR:
Checklist – Does the implementation plan meet the
following requirements?
Y/N
1. ALL hazards from the hazard inspection form must be
included.
Y
2. A specific action relating back to the risk assessment
matrix must be listed for each hazard.
Y
3. At least two persons must be listed as being responsible
for each action item.
Y
4. A specific completion date must be included for each
hazard if using the workplace pathway.
Y
5. A realistic monitoring plan must be provided for each
hazard to ensure it does not revert to the level of risk
prior to the controls being implemented.
Y
6. At least five control plans were implemented and
documented in the Implementation Log.
Y
7. At least two persons other than the student have
participated in implementing the control plan (will be
checked with the video submitted).
Y
Checklist – Does the implementation monitoring sheet
meet the following requirements?
Y/N
8. A brief description of the hazard area identified after the
control was implemented
Y
9. A date when the new inspection was conducted Y
10. Signature of supervisor/relevant personnel to
ensure that the inspection was conducted
Note: Applicable only to Workplace Pathway as
Simulated Pathway will be signed off by the Assessor.
Y