Worksite Assessment Guide (continued) Describe the physical arrangements of the health unit (equipment, space, and physical location within the organization). _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ Worker Population Total Number Employees _____ Percent Men _____ Percent Women _____ Age Range _____ Average Age _____ Percent Non-Production Employees _____ Percent Production Employees _____ Additional relevant comments about the characteristics of the workforce (e.g., ethnic diversity) _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ Shift Work: Percent Employees First Shift _____ Percent Employees Second Shift _____ Percent Employees Third Shift _____ Do workers rotate shifts? __________ If yes, what percentage of workers rotate shifts:______________ 345 Guideline continues on next page
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