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Canada University of Victoria Working Alone or In Isolation Check-In Form - British Columbia 2015-2025 free printable template

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Working Alone or In Isolation Checking Form Date: Individual Information: Department/ Area: Faculty Staff Student Last Name: First Name: Supervisor/ P.I. : Title: Last Name: First Name: Contact Person
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How to fill out Canada University of Victoria Working Alone or In Isolation

01
Start with the identification section: Fill in your name, date, and the department you belong to.
02
Specify the date and time you will be working alone or in isolation.
03
Indicate the location where you will be working.
04
Describe the nature of the work you will be doing during that time.
05
List any potential hazards associated with your work.
06
Outline the safety measures you will take to mitigate those risks.
07
Provide emergency contact information for yourself and any supervisors or colleagues.
08
Review the completed form for accuracy before submission.

Who needs Canada University of Victoria Working Alone or In Isolation?

01
Staff or faculty members conducting research or working on projects in isolated areas.
02
Students who are completing assignments or projects in facilities that might be vacant.
03
Employees who work irregular hours and might be in the workplace when others are not.
04
Anyone requiring clearance to work alone in locations deemed potentially hazardous.
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People Also Ask about

Individuals are alone at work when on their own; they cannot be seen or heard by another worker; cannot expect a visit from another worker for some time; and/or where assistance is not readily available when needed.
Workers who work alone Examples can include convenience store clerks, retail and food outlet workers, and taxi drivers.
Lone workers may be at increased risk of confrontations or even violence, particularly if they are on shift during late night hours. Lone workers must be able to get assistance if they are injured or there is an emergency. See our resources for information on ensuring the health and safety of lone workers.
Working alone includes all workers who may go for a period of time where they do not have direct contact with a co-worker. For example, the receptionist in a large office building may be considered a "lone" worker.
The risk assessment is to be completed by the supervisor in consultation with the worker assigned to work alone or in isolation. The results of the risk assessment will help identify the time interval between checks.
"Working alone" refers to working in situations where one is out of sight and hearing of others, when they do not expect a visit from another person and when assistance is not readily available in the event of a serious or critical injury, medical emergency, or victimization from workplace violence or criminal activity

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The Working Alone or In Isolation policy at the University of Victoria is designed to ensure the safety and well-being of individuals who may be working alone or in isolated conditions on campus.
All employees and students who plan to work alone or in isolation at the University of Victoria are required to file the necessary documentation to assess and mitigate potential risks.
To fill out the Working Alone or In Isolation form, individuals must provide details such as their name, location, time of work, and any potential hazards they may face while working alone.
The purpose of the policy is to identify risks associated with working alone or in isolation and to implement measures to ensure that individuals are safe during their work hours.
The information that must be reported includes the worker's name, contact information, specific location, expected duration of work, and any identified risks or safety concerns.
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