Home Office Safety Checklist Form
Please fill out this form completely to ensure your home office is safe and compliant with health and safety guidelines.
Personal Information
Checklist
# | Safety Item | Yes | No |
|---|
1 | Are your work areas well-lit? | | |
2 | Is your workstation ergonomically designed (e.g., proper chair, desk height)? | | |
3 | Do you have adequate ventilation in your office space? | | |
4 | Are electrical cords safely secured to avoid tripping hazards? | | |
5 | Is there a smoke detector installed in your office space? | | |
6 | Do you have an accessible first aid kit nearby? | | |
7 | Are your office supplies and equipment in good working condition? | | |
8 | Is there a fire extinguisher in your home office? | | |
9 | Are any chemicals or hazardous materials properly stored and labeled? | | |
10 | Do you have an emergency evacuation plan in place? | | |
Signature
By signing this form, I confirm that the information provided is accurate and that my home office meets the safety standards outlined above.
Name:
Date:
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