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The following items serve merely as an example of what might be used or modified by employers to help identify potential workplace violence problems.

This checklist helps identify present or potential workplace violence problems. Employers also may be aware of other serious hazards not listed here.

Designated competent and responsible observers can readily make periodic inspections to identify and evaluate workplace security hazards and threats of workplace violence. These inspections should be scheduled on a regular basis; when new, previously unidentified security hazards are recognized; when occupational deaths, injuries, or threats of injury occur; when a safety, health and security program is established; and whenever workplace security conditions warrant an inspection.

Periodic inspections for security hazards include identifying and evaluating potential workplace security hazards and changes in employee work practices which may lead to compromising security. Please use the following checklist to identify and evaluate workplace security hazards. TRUE notations indicate a potential risk for serious security hazards:

__T__F This industry frequently confronts violent behavior and assaults of staff.
__T__F Violence has occurred on the premises or in conducting business.
__T__F Customers, clients, or coworkers assault, threaten, yell, push, or verbally abuse employees or use racial or sexual remarks.
__T__F Employees are NOT required to report incidents or threats of violence, regardless of injury or severity, to employer.
__T__F Employees have NOT been trained by the employer to recognize and handle threatening, aggressive, or violent behavior.
__T__F Violence is accepted as "part of the job" by some managers, supervisors, and/or employees.
__T__F Access and freedom of movement within the workplace are NOT restricted to those persons who have a legitimate reason for being there.
__T__F The workplace security system is inadequate-i.e., door locks malfunction, windows are not secure, and there are no physical barriers or containment systems.
__T__F Employees or staff members have been assaulted, threatened, or verbally abused by clients and patients.
__T__F Medical and counseling services have NOT been offered to employees who have been assaulted.
__T__F Alarm systems such as panic alarm buttons, silent alarms, or personal electronic alarm systems are NOT being used for prompt security assistance.
__T__F There is no regular training provided on correct response to alarm sounding.
__T__F Alarm systems are NOT tested on a monthly basis to assure correct function.
__T__F Security guards are NOT employed at the workplace.
__T__F Closed circuit cameras and mirrors are NOT used to monitor dangerous areas.
__T__F Metal detectors are NOT available or NOT used in the facility.
__T__F Employees have NOT been trained to recognize and control hostile and escalating aggressive behaviors, and to manage assaultive behavior.
__T__F Employees CANNOT adjust work schedules to use the "Buddy system" for visits to clients in areas where they feel threatened.
__T__F Cellular phones or other communication devices are NOT made available to field staff to enable them to request aid.
__T__F Vehicles are NOT maintained on a regular basis to ensure reliability and safety.
__T__F Employees work where assistance is NOT quickly available.

*This form was taken from: Guidelines for Preventing Workplace Violence for Health Care and Social Service Workers. OSHA Publication 3148, (1996).