Construction Safety Competency Assessment Form
Evaluate your knowledge and practices related to construction site safety. Please answer all questions accurately.
Worker Name
*
First Name
Last Name
Job Role on Site
*
Please Select
Laborer
Foreman
Supervisor
Electrician
Plumber
Other
How would you rate your understanding of site-specific safety protocols?
*
1
2
3
4
5
Which of the following is the most important step before starting work on site?
*
Review the site safety plan
Begin work immediately
Wait for instructions
Other
How confident are you in identifying common construction hazards?
*
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
Which personal protective equipment (PPE) are you required to use on this site? (Select all that apply)
*
Hard hat
Safety glasses
High-visibility vest
Gloves
Steel-toe boots
Hearing protection
Other
In case of an emergency, what is your first action?
*
Notify supervisor
Evacuate the area
Call emergency services
Other
Rate your ability to follow safe lifting techniques.
*
1
2
3
4
5
Select the correct procedure for reporting a safety incident.
*
Please Select
Inform supervisor and fill out incident report
Ignore minor incidents
Wait until end of shift
Other
Evaluate your knowledge in the following safety areas:
*
Rows
Poor
Fair
Good
Excellent
Fall prevention
1
2
3
4
Electrical safety
5
6
7
8
Tool handling
9
10
11
12
Fire safety
13
14
15
16
Submit Assessment
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