Please complete this checklist prior to commencing a working from home arrangement (and review at least once a year at the EPDR) or if there are any changes e.g., Moving to a new house; changes to the equipment/furniture or any health/wellbeing issues arise). The completed form should submitted and will help the Company to ensure that your working conditions at home are safe and healthy.

Will your job involve any of the following whilst working from home? (please tick): –(required)

Is the room/area separate from other living areas in the home?(required)

Is the room/area used accessible without climbing a ladder?(required)

Is there enough space to safely accommodate all necessary furniture and equipment?(required)

Are walkways clear of tripping hazards, such as trailing cables?(required)

Is there a source of heating to maintain a comfortable temperature?(required)

Does the room have an opening window for ventilation?(required)

Is there adequate light to comfortably see documents and your computer screen?(required)

Can you reach storage shelves without having to stretch over the desk?(required)

Do you generally find your workstation comfortable to use?(required)

Do you know how your workstation should be arranged to achieve the most comfortable posture? (required)

Do you have somewhere secure to store confidential Company documents in order to maintain Data Protection Act?(required)

Do you use a computer/laptop at home for work purposes?(required)

Do you have to use a computer/laptop intensively on a regular basis when working from home?(required)

Does your electrical equipment have any signs of damage?(required)

If you have any items of Company equipment at home, are they marked to show they have received a portable appliance test?(required)

Do you know how to safely use the equipment you use to work from home?(required)

Do you have an escape plan in case of fire? (required)

Do you have a smoke alarm fitted? (required)

Do you know what to do in the event of having an accident at home? (required)

Do you have regular supervision with your line Manager? (required)

Do your working hours at home comply with the current Working Time Regulations? (required)

Does your Line manager review your working from home arrangements with you at supervision? (required)

Are you aware of the requirement of Arcus Attendance Procedure that requires you to report any sickness, whether working from home or at any other work base? (see sickness policy) (required)

Do you have the opportunity to contact and meet with other team members as appropriate (‘Home worker’ work style volunteers only)? (required)