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09 · Work Health and Safety Handbook — Confirmation

Mayim Group Pty Ltd (ABN 60 698 761 607), trading as Mayim Care

MC-QLD-DOC-09 · Version 1.0 · Queensland residential youth work
Questions: your reporting manager · admin@mayimcare.com.au · 0400 494 102

Full name as shown on your photo identification

Email address

Declaration

I have read the Work Health and Safety Handbook (MC-QLD-DOC-09, version 1.0) in full, I understand it, and I agree to comply with it. I understand my duties under section 28 of the Work Health and Safety Act 2011 (Qld) to take reasonable care for my own safety and that of others, comply with reasonable instructions, and cooperate with Mayim Care's policies. I understand that I must report every injury however minor, every instance of occupational violence or aggression including threats and near misses, and every hazard I cannot make safe. I understand that this form and my signature are a legal record kept on my personnel file.

I confirm the declaration above

Have you been shown the exits, evacuation route, assembly point, fire equipment, first aid kit, secured medication and chemicals, and the duress procedure for the house you are rostered to?

Yes

Not yet — I will ask before I am left alone in the house

Signature