ADI UK Supervisor HSE Gemba - Admin, Goods In Offices / Canteen

• Conducted on

  Date

• Prepared by

• Location
  Address

Goods In Office

• Any trip hazards from office equipment?

  Safe

  At Risk

  N/A

• Floors clean, dry and free of obstructions & trip / slip hazards?

  Safe

  At Risk

  N/A

• Tier 1 board up to date - review Cell Level Risk Assessment?

  Safe

  At Risk

  N/A

Admin Office

• Any trip hazards from office equipment?

  Safe

  At Risk

  N/A

• Floors clean, dry and free of obstructions & trip / slip hazards?

  Safe

  At Risk

  N/A

• Tier 1 board up to date - review Cell Level Risk Assessment?

  Safe

  At Risk

  N/A

Canteen

• Walkways & floors clean, dry and free of obstructions & trip / slip hazards?<br>(check for personal belongings, waste bins overflowing)

  Safe

  At Risk

  N/A

• Walkways & floors clean, dry and free of obstructions & trip / slip hazards?<br>(check for personal belongings, waste bins overflowing)

  Safe

  At Risk

  N/A

• Emergency exits clear of obstruction?

  Safe

  At Risk

  N/A

• Fridges and drink machines clean?

  Safe

  At Risk

  N/A

Employee Behaviours

Powered Device Operator Behavioural Observations Checks

• Powered device pre-start checklist completed?

  Safe

  At Risk

  N/A

• Device operator looking in the direction of travel?

  Safe

  At Risk

  N/A

• Device operator using horn / warning devices where required?

  Safe

  At Risk

  N/A

• Device operator wearing a seat belt?

  Safe

  At Risk

  N/A

• Device operator traveling at a speed suitable depending on amount of traffic, etc?

  Safe

  At Risk

  N/A

• Device operator adhering to “only Room for One” policy?

  Safe

  At Risk

  N/A

• Device operator vision impaired - clear view over the load?

  Safe

  At Risk

  N/A

Employee Behaviour Observation Checks

• Manual Handling Observations

  

• Evidence of heft test / is the employee aware of load contents?

  Safe

  At Risk

  N/A

• Is the employee adhering to a Good Posture / Loads suitable for manual handling?

  Safe

  At Risk

  N/A

• Is the employee over-stretching / twisting?

  Safe

  At Risk

  N/A

• Is the employee holding the load close to trunk?

  Safe

  At Risk

  N/A

• Is the employee wearing hi-visibility clothing, safety shoes (check condition)?

  Safe

  At Risk

  N/A

• Is the employee adhering to Cardinal Rules?

  Safe

  At Risk

  N/A

• Ceramic safety knives used, good working order?

  Safe

  At Risk

  N/A

• Is the employee wearing hand protection when handing pallets?

  Safe

  At Risk

  N/A

• Discuss unsafe observation programme with employee.

• Discuss evacuation procedure with employee.

• Discuss accident reporting with employee.

• Recognition - details below:

• Any recognition:

  Drawing