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LEVEL I ERGONOMIC EVALUATION (DATA SHEET)Employee Name: Job Title: Department: Supervisor: Address: Evaluator Name: Employee Telephone: Site Visit Date: Evaluation Procedure:Reminder: Neutral posture
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How to fill out level i ergonomic evaluation

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How to fill out level i ergonomic evaluation

01
Review the Level I Ergonomic Evaluation form and familiarize yourself with the different sections and questions.
02
Start by gathering relevant information about the employee, such as their job description, work environment, and any existing medical conditions or accommodations.
03
Begin the evaluation by assessing the employee's workstation setup. Check for proper ergonomics in terms of chair height, desk height, monitor position, keyboard/mouse placement, and any additional equipment or accessories.
04
Move on to evaluating the employee's work tasks and activities. Identify any repetitive or strenuous movements, awkward postures, or tasks that require excessive force.
05
Assess the employee's ability to perform their job duties comfortably and without excessive physical strain. Consider factors such as required reach distances, lifting or carrying objects, and other physical demands.
06
Inquire about any discomfort or pain the employee may be experiencing and document it accordingly. This can help identify potential ergonomic issues that need to be addressed.
07
Finally, provide recommendations for improvements based on your findings. These may include adjusting equipment, suggesting alternative work methods, implementing ergonomic training or exercises, or considering workplace modifications.
08
Complete the evaluation form by summarizing your findings, including any identified risks, recommended actions, and comments.
09
Share the evaluation results with the employee and their supervisor or relevant stakeholders, and ensure that any necessary follow-up actions are communicated and implemented.
10
Periodically review and update the evaluation as needed, especially if there are changes to the employee's job tasks, work environment, or any new medical conditions arise.

Who needs level i ergonomic evaluation?

01
Level I ergonomic evaluation is beneficial for any individual who spends a significant amount of time performing work tasks that involve physical strain, repetitive motions, awkward postures, or other ergonomic risk factors.
02
This evaluation is particularly relevant for employees who have recently started a new job, changed positions within their organization, or experienced any work-related discomfort or musculoskeletal issues.
03
Employers, human resources personnel, health and safety professionals, or ergonomic specialists may also initiate or require Level I ergonomic evaluations to proactively identify and mitigate occupational hazards, improve workplace conditions, and promote employee well-being and productivity.

What is LEVEL I ERGONOMIC EVALUATION (DATA SHEET) Form?

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Level I ergonomic evaluation is a basic assessment of workplace ergonomics to identify and address potential risk factors.
Employers are required to file a level I ergonomic evaluation for their workplace.
Level I ergonomic evaluation can be filled out by conducting an assessment of the workplace and documenting any ergonomic risk factors.
The purpose of level I ergonomic evaluation is to improve workplace ergonomics and prevent musculoskeletal injuries.
Level I ergonomic evaluation must include information on job tasks, workstation setup, and any identified ergonomic hazards.
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