DEPARTMENT OF OCCUPATIONAL SAFETY AND HEALTH

MINISTRY OF HUMAN RESOURCES

ERGONOMIC CHECKPOINTS
CHECKLIST AND IMPROVEMENTS RECORD

A. Company Particulars
Name :

Address :

Contact Person :
Telephone No. : Fax No. :
Email :
Commencement of
Operation :
DOSH Reg. No. :
Type of Industry :
No. of Workers : ( Male : ; Female : )

B. Assessment Particulars

Enabler Team
Name Contact No.
1.
2.
3.
4.

Assessment
1st (M1) 2nd (M2) 3rd (M4) 4th (M6) 5th (M9) 6th (M12)
Date of Assessment

Level Achieved (E)

Level Confirmation (V)
 [SOHELP] Ergonomic Checkpoints - Rev.02

ERGONOMICS CH
Check Point Date of
Description Evidence (Photos or Doc
Reference No. Implementation

A. Level 1 (Entry)
E1 Commitment from management to implement the Letter of Aggreement (LOA) from
programme. to participate in the programme

Yes No

E2 Appointment of Person in Charge (PIC) as an 'Enabler' Letter of appoinment for PIC Enab
to Implement the programme endorsed by management

Yes No

Notes: To proceed to the next level employer mus

LEVEL ACHIEVED : LE
B. Level 2 (Basic)
E3 PIC Enabler attended SOHELP Training program Certificate of attendance issued b

Yes No

E4 Provide a place for workers’ meeting & training Photo of meeting & training faciliti
Yes No

E5 PIC Enabler to conduct internal SOHELP training Records of attendance, photo, tra

Yes No

E6 PIC Enabler prepare action plan of the programme Gantt chart/ action plan on implem
SOHELP at the workplace
Yes No

Notes : To proceed to the next level employer mus

LEVEL ACHIEVED : LE
C. Level 3 (Intermediate)
E7 Conduct Screening of Ergonomics Risk Assessment Proactive approach:
(ERA) to ALL employees 1. Self-Assessment Musculoskele
Discomfort Survey Form; and
Yes No 2. Walkthrough inspection checkli
3. HIRARC/ JSA/ HRA, etc

Reactive approach:
4. MSDs complaint record; or
5. Request letter by OHD/ releven
E7 Proactive approach:
[SOHELP] Ergonomic
1. Checkpoints - Rev.02
Self-Assessment Musculoskele
Discomfort Survey Form; and
2. Walkthrough inspection checkli
3. HIRARC/ JSA/ HRA, etc

Reactive approach:
4. MSDs complaint record; or
5. Request letter by OHD/ releven

E8 Conduct Musculoskeletal Assessment to employees Result of Musculoskeletal Assess

who have been identified exposed to ergonomics risk
factors.Yes No

E9 Conduct Initial Ergonomics Risk Assessment (Initial Initial ERA Report

ERA)

Yes No

Name of ETP:
…………………………………………………………
…………………………………………………………

Date of Assessment:
…………………………………………………………

Notes : To proceed to the next level employer mus

LEVEL ACHIEVED : LE
D. Level 4 (Advance)
E10 Conduct Advanced Ergonomics Risk Assessment Advanced ERA Report
(Advance ERA)

Yes No N/A

Name of ETP:
…………………………………………………………
…………………………………………………………

Date of Assessment:
…………………………………………………………
 [SOHELP] Ergonomic Checkpoints - Rev.02

E11 Implement 50% of ergonomics control measure as 1. Control measure action plan.
recommended in ERA report 2. Photo of existing control measu
3. Photo of implemented control m
Yes No N/A

E12 Provide ergonomics awareness information and Proof of record is not only limited
training to employees 1. List of attendance
2. Training modules
Yes No 3. Training programmes

E13 Good record system 1. Self-assessment form

2. Complaint records or related m
Yes No 3. Walkthrough inspection and ini
4. Investigation reports
5. Assessment reports
6. Control measure reports
7. Training record

E14 Notification of work related Musculoskeletal Diseases

(WRMSD) to DOSH.

Yes No N/A

Notes : To proceed to the next level employer mus

LEVEL ACHIEVED : LE
E. Level 5 (Excellent)
E15 Implement all of ergonomics control measure as 1. Control measure action plan.
recommended in ERA report 2. Photo of existing control measu
3. Photo of implemented control m
Yes No N/A

E16 Implement ergonomic promotional activities 1. OSH activity schedule consists

related activities
2. Photo of activities i.e. OSH day
poster, buletin, etc..
 [SOHELP] Ergonomic Checkpoints - Rev.02

E16 1. OSH activity schedule consists

related activities
Yes No 2. Photo of activities i.e. OSH day
poster, buletin, etc..

E17 Review policy, budget and planning on OSH Company policy/ budget with OSH

Yes No

LEVEL COMPLE
LEVEL ACHIEVED : LE

Assessed By (SOHELP Enabler):

Assessment Date:
Level Achieved:
Remarks (Enabler):

Remarks (Verifier):
 [SOHELP] Ergonomic Checkpoints - Rev.02

NOMICS CHECKPOINT (Rev.02)

Evidence (Photos or Documents) Remark

Letter of Aggreement (LOA) from management

to participate in the programme

Letter of appoinment for PIC Enabler issued/

endorsed by management

oceed to the next level employer must full fill all the checkpoint in this level.
LEVEL ACHIEVED : LEVEL ……..

Certificate of attendance issued by the trainer

Photo of meeting & training facilities

Records of attendance, photo, training modules.

Gantt chart/ action plan on implementation of

SOHELP at the workplace

roceed to the next level employer must full fill all the checkpoint in this level.
LEVEL ACHIEVED : LEVEL ……..

Proactive approach:
1. Self-Assessment Musculoskeletal Pain/
Discomfort Survey Form; and
2. Walkthrough inspection checklist; and
3. HIRARC/ JSA/ HRA, etc

Reactive approach:
4. MSDs complaint record; or
5. Request letter by OHD/ relevent authorities
 [SOHELP] Ergonomic Checkpoints - Rev.02

Result of Musculoskeletal Assessment

Initial ERA Report

roceed to the next level employer must full fill all the checkpoint in this level.
LEVEL ACHIEVED : LEVEL ……..

Advanced ERA Report

 [SOHELP] Ergonomic Checkpoints - Rev.02

1. Control measure action plan.

2. Photo of existing control measures.
3. Photo of implemented control measures

Proof of record is not only limited to;

1. List of attendance
2. Training modules
3. Training programmes

1. Self-assessment form
2. Complaint records or related medical records
3. Walkthrough inspection and initial findings
4. Investigation reports
5. Assessment reports
6. Control measure reports
7. Training record

roceed to the next level employer must full fill all the checkpoint in this level.
LEVEL ACHIEVED : LEVEL ……..

1. Control measure action plan.

2. Photo of existing control measures.
3. Photo of implemented control measures

1. OSH activity schedule consists of ergonomics

related activities
2. Photo of activities i.e. OSH day, seminar,
poster, buletin, etc..
 [SOHELP] Ergonomic Checkpoints - Rev.02

Company policy/ budget with OSH consideration

LEVEL COMPLETE
LEVEL ACHIEVED : LEVEL ……..
 [SOHELP] Ergonomic Checkpoints - Rev.02

ECKPOINT (Rev.02)

Standard Activity

Yes - Employer issued LOA to show their commitment in

SOHELP programme.

No - No LOA issued by employer for this programme

Yes - Employer appoints the PIC Enabler by issuing a letter of

appointment
No - PIC not appointed

Notes - The company should appoint a person to be in-charge

to implement the SoHELP programme. Appointment should be
formally evident by a letter of PIC appointment specifically for
all the checkpoint in this level.
the programme.
..

Yes - PIC Enabler attended the SOHELP training conducted

by Verifier or others training provider recognised by DOSH.

No - PIC Enabler did not attend any SOHELP Training.

Yes - Employer provide proper place for worker’s meeting &

training (training room, meeting room and etc)
No - No proper place provided

Notes - Inline with Reg. 22 SHC Reg. 1996

Yes – PIC to organize and conduct internal SOHELP training

to SHC/ workers/ etc..

No – PIC Enabler did not conduct the internal SOHELP

training.
Yes – PIC Enabler prepared Gantt chart/ action plan for
SOHELP programme consist of planning and action to be
taken for each checkpoint.

No – No action plan prepared by PIC Enabler.

all the checkpoint in this level.

..

Yes – Screening of ERA has been conducted by employer or

Ergonomics Trained Person (ETP) to ALL employees through
proactive or reactive approaches:

Proactive:
A. Self-Assessment Musculoskeletal Pain/ Discomfort Survey
Form
B. Walkthrough inspection
C. Review of records - HIRARC, Job safety Analysis (JSA) or
Health Risk Assessment (HRA)
 Yes – Screening of ERA has been conducted by employer or
[SOHELP]
Ergonomics Trained Person (ETP) to ALL employees Ergonomic Checkpoints - Rev.02
through
proactive or reactive approaches:

Proactive:
A. Self-Assessment Musculoskeletal Pain/ Discomfort Survey
Form
B. Walkthrough inspection
C. Review of records - HIRARC, Job safety Analysis (JSA) or
Health Risk Assessment (HRA)

Reactive:
D. Receive ergonomics related injuries or MSDs complaints
E. Requested by OHD or relevant authorities

No – Screening of ERA not conducted

Notes:
Refer figure 2.1 in Guidelines on ERA 2017

Yes – Musculoskeletal Assessment conducted by ETP.

No – Musculoskeletal Assessment not conducted

Notes - Refer Appendix 3 in Guidelines on ERA 2017

Yes – Initial ERA conducted by ETP.

No – Initial ERA not conducted.

Notes - Refer Appendix 6 in Guidelines on ERA 2017 for

example of initial assessment methods.

all the checkpoint in this level.

..

Yes – Advanced ERA conducted by ETP.

No – Advanced ERA not conducted.

N/A - If results of Initial ERA do not require Advanced ERA

Notes - Refer Appendix 5 in Guidelines on ERA 2017 for

example of assessment advanced methods.
 [SOHELP] Ergonomic Checkpoints - Rev.02

Yes – Employer implement 50% of ergonomics control

measure as recommended in ERA report

No – Employer not implement 50% of ergonomics control

measure as recommended in ERA report

N/A - No recommendation for ergonomics control measure

since existing control is adequate.

Yes – Employer have provided ergonomics awareness

information and training. Topics not limited to:
1. Ergonomics risk factor
2. Sign and symptoms of ergonomics related injuries and
MSDs
3. Correct manual handling techniques
4. Skills and knowledge to perform works that meets
ergonomics requirements
5. Control measures for mitigating ergonomics related injuries
and MSDs

No – Employer not provided any ergonomics awareness

information and training.

Yes - Employer have keep and maintain a record which

inluclude the following documents:
1. Self-assessment form
2. Complaint records or related medical records
3. Walkthrough inspection and initial findings
4. Investigation reports
5. Assessment reports
6. Control measure reports
7. Training record

No - Employer have not keep and maintain any record.

Yes – Employer notified cases of WRMSD to DOSH.

No – Employer not notify cases of WRMSD to DOSH.

NA - No case of WRMSD

all the checkpoint in this level.

..

Yes – Employer implemented all of ergonomics control

measure as recommended in ERA report

No – Employer not implement all of ergonomics control

measure as recommended in ERA report

N/A - No recommendation for ergonomics control measure

since existing control is adequate.

Yes - Employer provide promotional activities of ergonomics

management among the employees.

No – No promotion planned on ergonomics management.

 [SOHELP] Ergonomic Checkpoints - Rev.02

Yes - Employer provide promotional activities of ergonomics

management among the employees.

No – No promotion planned on ergonomics management.

Yes – Employer/ PIC Enabler reviewed policy, budget and

planning on OSH

No – Employer/ PIC Enabler did not review policy, budget and

planning on OSH

Notes - In order to achieve checkpoint E17, the employer need

to review the company’s policies, budget and plan activities
with regards to OSH. This policies, activities and budget should
include matters pertaining to ergonomic issues at the
workplace.

..