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Vancouver Island West School District 84 REFUSAL OF UNSAFE WORK INVESTIGATION REPORT To be filled out by Supervisor and Employee or Worker Representative. NOTE: If additional space is required, please
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How to fill out refusal of unsafe work

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How to fill out a refusal of unsafe work:

01
Identify the unsafe conditions or hazards present in your work environment. This could include things like faulty equipment, inadequate training, or dangerous substances.
02
Immediately notify your supervisor or manager about the unsafe conditions. Clearly explain the specific issues and why you believe the work is unsafe. Provide any relevant evidence or documentation if available.
03
If your supervisor or manager fails to address the unsafe conditions and insists that you continue working, it is important to follow your organization's specific procedure for refusing unsafe work. This usually involves filling out a refusal of unsafe work form.
04
Find and complete the refusal of unsafe work form. This form typically requires you to provide details about the specific hazards or conditions, the date and time of refusal, and any actions taken or requests made to address the issue.
05
Consult any applicable health and safety regulations or policies to ensure you are providing all necessary information on the form. This may include citing specific sections or guidelines that support your refusal.
06
Once you have completed the form, submit it to the appropriate person or department as outlined in your organization's procedure. This could be your supervisor, HR department, or an occupational health and safety representative.

Who needs refusal of unsafe work?

01
Employees who have identified hazardous conditions or unsafe practices in their work environment.
02
Employees who have notified their supervisor or manager about the unsafe conditions but have not received a satisfactory resolution.
03
Employees who are concerned about their health and safety and want to protect themselves from potential harm in the workplace.
Note: It is important to familiarize yourself with your organization's specific procedure for refusing unsafe work, as it may vary depending on the company and industry.
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Refusal of unsafe work is when an employee refuses to perform a task or job that they believe is unsafe.
Any employee who believes that the work they are being asked to do is unsafe can file a refusal of unsafe work.
To fill out a refusal of unsafe work, the employee must notify their supervisor or employer in writing that they are refusing to do the work because they believe it to be unsafe.
The purpose of refusal of unsafe work is to protect employees from being forced to work in hazardous conditions that could put their health or safety at risk.
The refusal of unsafe work report should include details about the specific task or job being refused, the reasons why it is believed to be unsafe, and any steps taken to address the concern.
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