CHECKLIST

WORKPLACE VIOLENCE PREVENTION ENVIRONMENTAL HAZARD ASSESSMENT & CONTROL CHECKLIST

This checklist can help you or your workplace violence/crime prevention committee to evaluate the workplace and job tasks to see what situations may place employees at risk of assault. It is not confined to a single industry or occupation but can be used for any workplace. Adapt the checklist to fit your own needs. It is very comprehensive and not every question will apply to your workplace, write "N/A" in the NOTES column. Add any other questions you think are important.

RISK FACTORS FOR WORKPLACE VIOLENCE

Cal/OSHA and NIOSH have identified the following risk factors that may contribute to violence in the workplace. If you have one or more of these risk factors in your workplace, there may be a potential for violence.

YES	NO		NOTES/FOLLOW-UP ACTION
		Do employees have contact with the public?
		Do they exchange money with the public?
		Do they work with, guard, or transport valuable items like money, jewelry, or other property?
		Do they work alone?
		Do they work late at night or during early morning hours?
		Is the workplace often understaffed?
		Is the workplace located in an area with a high crime rate?
		Do employees enter areas with a crime rate?
		Do they have a mobile workplace (CHP vehicle, work van, etc)?
		Do they deliver passengers or goods?
		Do employees perform public safety functions that might put them in conflict with others?
		Do they ever perform duties that could upset people (deny benefits, turn off utilities, collect debts, confiscate property, terminate child custody, etc.)?
		Do they deal with people known or suspected to have a history of violence?
		Do any employees or supervisors have a history of assault, verbal abuse, harassment, or other threatening behavior?

Other risk factors (please describe):

INSPECTING WORK AREAS

Who is responsible for building security? ____________________________________

Are employees told who is responsible for security? p Yes p No

You or your workplace violence/crime prevention committee should now begin a "walkaround" inspection to identify potential security hazards. This inspection can tell you which hazards are already well controlled, and what control measures need to be added. Not all of the following questions can be answered through simple observation. You may also need to talk to employees or investigate in other ways.

All Areas	Some Areas	Few Areas	No Areas		NOTES/FOLLOW-UP ACTION
				Are nametags, ID cards required for employees (omitting personal information such as home address)?
				Are employees notified of past violent acts in the workplace?
				Are there trained security personnel, accessible to employees in a timely manner?
				Do security personnel have sufficient authority to take all necessary action to ensure employee safety?
				Is there established liaison with CHP and/or local police?
				Are bullet resistant windows or similar barriers used when money is exchanged with the public?
				Are areas where money is exchanged visible to others who could help in an emergency? (For example, you can see cash register areas from outside)?

All Areas	Some Areas	Few Areas	No Areas		NOTES/FOLLOW-UP ACTION
				Is a limited amount of cash kept on hand, with appropriated signs posted?
				Could someone hear a employee who called for help?
				Can employees observe patients or clients in waiting areas?
				Do areas used for patient or client interviews allow co-employees to observe any problems?
				Are waiting areas and work areas free of objects that could be used as weapons?
				Are chairs and furniture secured to prevent use as weapons?
				Is furniture in waiting areas and work areas arranged to prevent entrapment of employees?
				Is patient or client waiting areas designed to maximize comfort and minimize stress?
				Are patients or clients in waiting areas clearly informed how to use the department’s services so they will not become frustrated?
				Are waiting times for patient or client services kept short to prevent frustration?
				Are private, locked restrooms available for staffemployees?
				Is there a secure place for employees to store personal belongings?

INSPECTING EXTERIOR BUILDING AREAS

Yes	No		NOTES/FOLLOW-UP ACTION
		Do employees feel safe walking to and from the workplace?
		Are the entrances to the building clearly visible from the street?
		Is the area surrounding the building free of bushes or other hiding places?
		Are security personnel provided outside the building?
		Is video surveillance provided outside the building?
		Is there enough lighting to see clearly outside the building?
		Are all exterior walkways visible to security personnel?

4. INSPECTING PARKING AREAS

Yes	No		NOTES/FOLLOW-UP ACTION
		Is there a nearby parking lot reserved for employees only?
		Is the parking lot attended or otherwise secured?
		Is the parking lot free of bushes or other hiding placesIs the parking lot free of blind spots and is landscaping trimmed back to prevent hiding places?
		Is there enough lighting to see clearly in the parking lot and when walking to the building?
		Are security escorts available to employees walking to and from the parking lot?

5. SECURITY MEASURES

In Place	Should Add	Doesn’t Apply	Does the workplace have:	NOTES/FOLLOW-UP ACTION
			Physical barriers (plexiglass partitions, bullet resistantproof customer windows, etc.)?
			Security cameras or closed circuit TV in high-risk areas?
			Panic buttons?
			Alarm systems?
			Metal detectors?
			X-ray machines?
			Door locks?
			Internal telephone system to activate emergency assistance?
			Telephones with an outside line programmed for 911?
			Two-way radios, pagers, or cellular telephones?
			Security mirrors (e.g. convex mirrors)?
			Secured entry (e.g. "buzzers")?
			Personal alarm devices?
			"Drop safes" to limit amount of cash on hand?
			Broken windows repaired promptly?
			Security systemsdevices, locks, etc. tested on a regular basis and repaired promptly when necessary?

COMMENTS

Checklist completed by: _____________________________ Date: ____________________

Department/Location: __________________________ Phone Number: ________________

Workplace Violence Prevention Program Assessment Checklist

Use this checklist as part of a regular safety and health inspection or audit that is conducted by the Health & Safety, Crime/Workplace Violence Prevention Coordinator, or joint labor/management committee. If a question does not apply to the workplace, then write "N/A" (not applicable) in the note column. Add any other questions that may be appropriate.

Yes	No	STAFFING	NOTES
		Is there someone responsible for building security?
		Who is it?
		Are employees told who is responsible for security?
		Is adequate and trained staffing available to protect employees against assaults or other violence?
		Is there a "buddy system" for when employees are in potentially dangerous situations?
		Are there trained security personnel accessible to employees in a timely manner?
		Do security personnel have sufficient authority to take all necessary action to ensure employee safety?
		Are security personnel provided outside the building?
		Is the parking lot attended or otherwise secure?
		Are security escorts available to walk employees to and from the parking lot?
		TRAINING
		Are employees trained in the emergency response plan (for example, escape routes, notifying the proper authorities)?
		Are employees trained to report violent incidents or threats?
		Are employees trained in how to handle difficult clients or patients?
		Are employees trained in ways to prevent or defuse potentially violent situations?
		Are employees trained in personal safety and self-defense?

Yes	No	FACILITY DESIGN
		Are there enough exits and adequate routes of escape?
		Can exit doors be opened only from the inside to prevent unauthorized entry?
		Is the lighting adequate to see clearly in indoor areas?
		Are there employee-only work areas that are separate from public areas?
		Is access to work areas only through a reception area?
		Are reception and work areas designed to prevent unauthorized entry?
		Could someone hear a employee call for help?
		Can employees observe patients or clients in waiting areas?
		Do areas used for patient or client interviews allow coemployees to observe any problems?
		Are waiting and work areas free of objects that could be used as weapons?
		Are chairs and furniture secured to prevent use as weapons?
		Is furniture in waiting and work areas arranged to prevent employees from becoming trapped?
		Are patient or client areas designed to maximize comfort and minimize stress?
		Is a secure place available for employees to store their personal belongings?
		Are private, locked restrooms available for staff?
		SECURITY MEASURES - Does the workplace have?
		Physical barriers (Plexiglas partitions, elevated counters to prevent people from jumping over them, bullet resistant customer windows, etc.)?
		Security cameras or closed circuit TV in high-risk areas?
		Panic buttons -(portable or fixed)?

Yes	No	SECURITY MEASURES - Does the workplace have? (cont.)
		Alarm systems?
		Metal detectors?
		X-ray machines?
		Door locks?
		Internal phone system to activate emergency assistance?
		Phones with an outside line programmed to call 911?
		Security mirrors (convex mirrors)?
		Secured entry (buzzers)?
		Personal alarm devices?
		OUTSIDE THE FACILITY
		Do employees feel safe walking to and from the workplace?
		Are the entrances to the building clearly visible from the street?
		Is the area surrounding the building free of bushes or other hiding places?
		Is video surveillance provided outside the building?
		Is there enough lighting to see clearly outside the building?
		Are all exterior walkways visible to security personnel?
		Is there a nearby parking lot reserved for employees only?
		Is the parking lot free of bushes or other hiding places?
		Is there enough lighting to see clearly in the parking lot and when walking to the building?
		Have neighboring facilities and businesses experienced violence or crime?
		WORKPLACE PROCEDURES
		Is public access to the building controlled?
		Are floor plans posted showing building entrances, exits, and location of security personnel?
		Are these floor plans visible only to staff and not to outsiders?
		Is other emergency information posted, such as telephone numbers?

Yes	No	WORKPLACE PROCEDURES (cont.)
		Are special security measures taken to protect people who work late at night (escorts, locked entrances, etc.)?
		Are visitors or clients escorted to offices for appointments?
		Are authorized visitors to the building required to wear ID badges?
		Are identification tags required for staff (omitting personal information such as the person's last name and social security number)?
		Are employees notified of past violent acts by particular clients, patients, etc.?
		Is there an established liaison with local police?
		Are patients or clients in waiting areas clearly informed how to use the department's services so they will not become frustrated?
		Are waiting times for patient or client services kept short to prevent frustration?
		Are broken windows and locks repaired promptly?
		Are security devices (locks, cameras, alarms, etc.) tested on a regular basis and repaired promptly when necessary?
		FIELD WORK - Staffing:
		Is there adequate staffing in the field?
		Are escorts or "buddies" provided for people who work in potentially dangerous situations?
		Is assistance provided to employees in the field in a timely manner when requested?
		FIELD WORK - Training:
		Are employees briefed about the area in which they will be working (gang colors, neighborhood culture, language, drug activity, etc.)?
		Can employees effectively communicate with people they meet in the field (same language, etc.)?
		Are people who work in the field late at night or early mornings advised about special precautions to take?

Yes	No	FIELD WORK - Work Environment:
		Is there enough lighting to see clearly in all areas where employees must go?
		Are there safe places for employees to eat, use the restroom, store valuables, etc.?
		Are there places where employees can go for protection in an emergency?
		Is safe parking readily available for employees in the field?
		FIELD WORK - Security Measures:
		Are employees provided two-way radios, pagers, or cellular phones?
		Are employees provided with personal alarm devices or portable panic buttons?
		Are vehicle door and window locks controlled by the driver?
		Are vehicles equipped with physical barriers (Plexiglas partitions, etc.)?
		FIELD WORK - Work Procedures:
		Are employees given maps and good directions covering the areas where they will be working?
		Are employees given alternative routes to use in neighborhoods with a high crime rate?
		Does a policy exist to allow employees to refuse service to clients or customers (in the home, etc.) in a hazardous situation?
		Has a liaison with the police been established?
		Do employees avoid carrying unnecessary items that someone could use as a weapon against them?
		Does the employer provide a safe vehicle or other transportation for use in the field?
		Are vehicles used in the field routinely inspected and kept in good working order?
		Is there always someone who knows where each employee is?
		Are nametags required for employees in the field (omitting personal information such as last name and social security number)?
		Are employees notified of past violent acts by particular clients, patients, etc.?

Yes	No	FIELD WORK - Are special precautions taken when employees:
		Perform "enforcement" functions (parking control officers, inspectors, etc.)?
		Have to take something away from people (remove children from the home) utilities, etc.)?
		Have contact with people who behave violently?
		Use vehicles or wear clothing marked with the name of an organization that the public may strongly dislike?
		Perform duties inside people's homes?
		Have contact with dangerous animals (dogs, etc.)?