WORKING FROM HOME SELF ASSESSMENT CHECKLIST

This checklist is to be completed by staff members intending to work from home. This checklist should be completed by the staff member applying to work from home and should be reviewed by the manager prior to the staff member commencing a working from home arrangement to determine if the home work area is appropriate and or if any equipment or furniture is required.

Employee Details:
Employee Name:
Position Title:
Phone:
Email:
Address of home:
Describe premises and office location (e.g. back of house, top floor with carpeted floor, access to first aidetc:
Manager Details:
Manager Name:
Position Title:
Phone:
Email:
Checklist:
CHAIR
The chair is easily adjusted from a seated position (Seat back height & angle, seat height) / Yes No N/A
The seat back is adjusted so the lumbar support of the chair supports the lower back / Yes No N/A
The forearms and wrists are parallel to the floor or angled down slightly when chair height adjusted / Yes No N/A
When chair height is adjusted appropriately, the feet are positioned on the ground / Yes No N/A
If feet are not positioned on the ground, a foot rest is provided / Yes No N/A
Seat back angle is adjusted so user is in an upright position when using keyboard / Yes No N/A
WORKSTATION DESK
Desk is large enough for the completion of mixed tasks (computer and reading / writing)
(Australian Standard 4442:1997 advises this should be at least 1600mm x 800mm) / Yes No N/A
Desk is between 680mm and 735 mm high / Yes No N/A
If desk is height adjustable - is this easily adjusted? Adjusted so forearms are parallel to floor or angled down slightly? / Yes No N/A
Desk is designed so frequent trunk twisting / rotation is not required / Yes No N/A
User is able to sit close to workstation without any impediment
(Check that the desktop is thin, chair arms are not in the way, clear leg room) / Yes No N/A
If documents are regularly referred to, they can be positioned & supported (ie. use of document holder, or desk slope) to avoid unnecessary neck movement (looking sideways / downwards). / Yes No N/A
MONITOR
Is positioned at approximately an arms distance when in an upright seated position / Yes No N/A
Is positioned at an appropriate height (neck remains in a neutral position - not required to look upwards or downwards to view monitor) / Yes No N/A
If using a laptop, this is either raised, or this is positioned on a docking station / Yes No N/A
Monitor is positioned away from direct light sources and is free from glare / reflection / Yes No N/A
KEYBOARD AND MOUSE
Elbows remain close to side of body when keyboard and mouse are utilised / Yes No N/A
Mouse is at the same level as the keyboard / Yes No N/A
Separate keyboard and mouse is used if utilising laptop computer for extended periods / Yes No N/A
WORK ENVIRONMENT
Lighting is adequate (able to read / refer to documentation without eye strain) / Yes No N/A
Noise levels are not distracting from task concentration / Yes No N/A
Ventilation (natural or artificial) is adequate / Yes No N/A
Electrical safety considered – safety switch in place, cords not across floors / Yes No N/A
DATE COMPLETED:
Actions or equipment required:
List any actions or equipment (eg. document holder, monitor stand) or modifications (eg. workstation adjustments) required:

Forward completed form with photo of workstation and office environment to the HR department at

Signatures:
Employee: / Signature: / Date:
Manager: / Signature: / Date:
Risk Management Review:
Date Received:
Comments:
HR department: / Signature: / Date:

Appendix

Recommendation for Adjusting Your Workstation

Height Adjustable Workstations

Adjust the height of your chair so that your feet are flat on the floor, and that your thighs are horizontal (form a right angle at the knees). There should be no pressure on the underside of your thighs. (See figure below)

/ •Feet adequately supported
•Thighs are parallel to the floor
•Elbows and upper arms close to the body
•Shoulders relaxed
•Forearms horizontal, wrists in a natural comfortable position
•Head upright or inclined slightly forward in a relaxed position
•Lower back is supported

Recommended Sitting Position as a Starting Point.

Then, adjust your workstation (desk) height until:

  • your shoulders are relaxed with upper arms close to body,
  • your forearms are approximately horizontal; AND
  • your wrists are straight when you are keying.

Non-Height Adjustable Workstations

Sit at the workstation and adjust your chair height until:

  • shoulders are relaxed with upper arms close to body,
  • your forearms are approximately horizontal; AND
  • your wrists are straight when you are keying.
  • Make sure your thighs are horizontal and that your feet are flat on the floor. If they are not, use a footrest to raise the feet until the pressure on the underside of the thighs is reduced.

If you have problems in finding a comfortable working height for the workstation, talk to your manager - you may need to lower or raise the height.

Chair

  • Adjust the backrest forwards or backwards to give your back appropriate support.
  • Adjust the backrest height of the chair so that the curve of the back support fits comfortably in the curve of your back (about the waist).
  • Make sure your chair arms do not interfere with your posture or keying technique.

Computer

  • Position your computer so that you can sit directly in front of it.
  • If using a laptop computer for prolonged periods in the office place on a pedestal/monitor stand and use an external mouse and keyboard.
  • Your screen should be at about arm's length or a bit more and the top should be at eye-level or slightly below. (if you wear multifocal glasses you may prefer the screen to be lower).
  • Position your keyboard directly in front of your body and the mouse so that you don’t have to reach forwards or sideways.

Layout

  • Place all often-used items within easy reach? ie normal arm reach
  • Is there sufficient space for large documents, completed work or writing?
  • Is there sufficient space for equipment and hard copy materials?
  • Is the workstation designed to prevent undue twisting of the neck or body?

Prevent Visual Fatigue

  • Remove or reduce any source of glare or reflections.
  • Adjust the screen brightness and contrast so that it is comfortable to your eyes.
  • Regularly look away from the screen and off into the distance (at least 6 metres).