Electrical Safety Competency Assessment Form
Evaluate your knowledge and practical skills in electrical safety procedures and hazard prevention.
Which of the following is the most important first step before working on any electrical equipment?
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Turn off the power supply
Wear rubber gloves
Notify your supervisor
Check the equipment label
Rate your confidence in identifying electrical hazards in your work environment.
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1
2
3
4
5
Which type of fire extinguisher is safe to use on an electrical fire?
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Water
Foam
Carbon Dioxide (CO2)
Wet Chemical
How often should electrical equipment be inspected for safety hazards?
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Once a year
Before each use
Every five years
Only when a problem is suspected
Rate your ability to select and use appropriate personal protective equipment (PPE) for electrical work.
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Not confident
1
2
3
4
Highly confident
5
1 is Not confident, 5 is Highly confident
Select all actions that help prevent electrical shock.
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Keep work area dry
Use insulated tools
Wear metal jewelry
Disconnect power before maintenance
Use extension cords with exposed wires
Indicate your agreement with the following statements about electrical safety practices.
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Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I always verify power is off before starting work.
1
2
3
4
5
I report damaged cords immediately.
6
7
8
9
10
I avoid using equipment with frayed wires.
11
12
13
14
15
What is the appropriate response if you witness a coworker receive an electric shock?
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Pull them away from the source immediately
Turn off the power and call for help
Splash water on them
Wait for them to recover on their own
How would you identify a live wire in a multi-wire system?
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By its color code
By touching it
By its thickness
By asking a coworker
Rate your familiarity with lockout/tagout (LOTO) procedures for electrical safety.
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Not familiar
1
2
3
4
Very familiar
5
1 is Not familiar, 5 is Very familiar
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