Work Experience Placement Assessment Form

PLACEMENT EMPLOYER RISK ASSESSMENT FOR YOUNG PERSONS

Health and Safety Standard (10)

Learning activities: Painting and decorating activities. Learner’s name/School____________________

(if applicable)

Activities undertaken by Employer’s

student ______________________________ Name. ___________________________

Key tasks, locations & areas
Movement around site.
Vehicle movement around site.
Using hand tools. (Not wood saws,
wood chisels or Stanley knives)
Objects falling from height.
Noise Pollution.
Manual handling.
Atmospheric pollution (i.e. Dust).
Others please add as appropriate.
Hazards and significant risks Risk control measures 
Slips, trips and falls. Induction, Training and Supervision.
Death or serious injury. Induction, Training and Supervision.
PPE (high visibility jacket).
Cuts, grazes and piercing. Induction, Training and Supervision.
PPE (gloves, goggles).
Death or serious injury. Strict site management and PPE (hard
hat).
Ear damage. PPE (Ear defenders).
Muscular strains and skeletal damage. Induction, Training, Supervision and strict
manual handling procedures.
Inhalation of dust, grit and fumes. PPE (Facemasks).

Prohibited tasks, areas or work equipment. Restricted tasks, areas or work equipment.
Prohibited from using power machinery and power tools. Restricted working at height (2 metres only).
Prohibited working on ladders. Restricted to 1st floor level of scaffolding.
Prohibited using chemicals (concentrated products/COSHH label). Restricted use of ladder to 1st floor only (ladder must be tied).
Prohibited use of petrol. Restricted battery air tools allowed if there is a brake, and under
Prohibited new build sites (below ground works only). strict supervision.
Prohibited running errands.
Detail any relevant learning/behavioural difficulties, disabilities or medical/health conditions that may be restrictive or require
special consideration prior to the young person starting their work placement.

For the duration of the work experience period the student MUST be continually supervised and monitored.

We agree to conform to the above restrictions and undertakings Signed

during the work experience period and agree to review this risk ……………………………………………………………………….
assessment in the light of any changes and to inform VT
Enterprise accordingly. Dated
………………………………………………………………………..

Please note the information in the highlighted section is a guide for the Assessor and is not present in the employer version.