Health & Safety Committee Member Assessment Form

HEALTH & SAFETY COMMITTEE MEMBER ASSESSMENT FORM

This form is designed to assess the performance and contributions of members of the Health & Safety Committee at [Your Company Name]. The assessment is conducted to ensure the effectiveness of the Committee and the commitment of its members towards maintaining and improving health and safety standards in the workplace.

Assessment Criteria

Description

Rating

(1-5)

Evaluator's

Comments

Participation in Meetings

Regular attendance and active participation in meetings.

4

Consistently active in discussions.

Evaluator's Summary:

Provide a brief overall assessment of the Committee member's performance, noting any areas of strength or needed improvement.

The member has shown commendable dedication to health and safety standards, particularly in areas of policy knowledge and compliance monitoring. Their proactive approach in regular meetings has contributed significantly to the committee’s objectives.

Member's Self-Assessment:

Member's Comments:

Action Plan:

Outline any recommended actions or development plans for the member.

Evaluator's Signature:

[Your Name]

[Job Title]

[Month Day, Year]

Member's Signature:

[Name]
[Job Title]

[Month Day, Year]

This form is a part of [Your Company Name]'s commitment to maintaining a high standard of health and safety in the workplace. The feedback provided will be used to enhance the effectiveness of our Health & Safety Committee.

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