Ladder Safety Test

1
Name* This field is required.Please write your name
First Name
Last Name
2
Employee Number
3
Branch* This field is required.Please select your branch
ABS
ARS
Augusta, GA
Castleton, ND
Cedar Rapids, IA
Clara City, MN
Clinton, IA
David City, NE
Decatur, Al
Decatur, IL
Des Moines, IA
Fredonia, KS
Fredonia Shop, KS
Ft. Lawn, SC
Gastonia, NC
Lincoln, NE
Mankato, MN
Marshall, MN
Mexico, MO
Mitchell, SD
TFC
Urbana, IA
Valdosta, GA
West Monroe, LA
4
Safety Instructor CR* This field is required.Please Select
Kris Catlin
Pat Roof
Chad Wieland
Harry Foley
5
Safety Instructor Please type the name of your safety instructor.
6
Meeting Location CR* This field is required.
Dry Grind
Warehouse 2
Warehouse 4
Warehouse 9
7
Meeting Location Please type where the Safety Instruction took place.
8
Another team member has completed the JHA for your task and you notice a potential hazard not listed. How do you handle this?* This field is required.
Add the potential hazard to the JHA and let everyone know.
Do not modify the completed JHA. Save it for your turn to complete the JHA.
Do nothing.
9
Your JHA says you should have a face shield for the job. You do not have one. How do you proceed?* This field is required.
Make sure your safety glasses are snug fit and continue your task carefully.
Disregard the face shield requirement. It could have been a mistake.
Before continuing, check with a supervisor. If a face shield is required get one before work proceeds.
10
You are reviewing the JHA for your task but it is hard to read the hand writing on the JHA. What now?* This field is required.
Since you have done this job before don´t worry about it. Go ahead and sign.
Get your supervisor to review the JHA with you.
Since you can´t read it don´t add your name to it. continue the task without signing.
11
You notice that the detailed hazard explanation doesn´t match the detail of the plan to control or eliminate the hazard. How do you fix this?* This field is required.
Review the JHA with your supervisor and come up with a correction.
Do nothing since it is only a potential hazard.
Simply make the corrections yourself and continue with your work.
12
It is the end of the shift and you are ready to sign off of the JHA but remember hitting your arm. The JHA asks if you have been involved with an incident, injury, or damage. What do you do?* This field is required.
If your arm feels mostly good, check "NO" and prevent making a fuss.
Mark "YES". Tell your supervisor. This is our chance to prevent a mishap from happening again in the future.
Mark "YES". Do not tell your supervisor. Your arm will probably be better tomorrow and this was just a minor incident.
13
Initials* This field is required.Make sure to go to the next screen to submit
14
PercentageTo be considered a passing score, you must achieve a 70% or better. If not, review material and try again. Hit submit and wait for the thank you page.
15
Please Check* This field is required.
Should be Empty: