Home Office Safety Self-Assessment Form
Employee Information
Workstation Ergonomics
Is your chair adjustable and supportive?
Is your monitor at eye level?
Is there enough lighting at your workstation?
Electrical Safety
Are electrical cords in good condition?
Are power outlets not overloaded?
Are surge protectors being used?
Fire Safety
Is there a smoke detector nearby?
Is there an accessible fire extinguisher?
Are exits clear from obstructions?
Environment & Emergency
Is the space free of trip hazards?
Do you know emergency procedures?
Additional Comments