BBS Observation

• Date

  Date

• Employee Observed

• Observed By

• Jobsite

• Location
  Address

Initial actions

• Required Training for Task Observed

  Select Safety Orientation Elevated Work Platform (EWP) Aerial and Scissor Lifts Driving Safety Excavation/Trenching Fall Protection Forklift Lockout/Tagout (LOTO) Respiratory Protection Silica OSHA

  • Safety Orientation
  • Elevated Work Platform (EWP) Aerial and Scissor Lifts
  • Driving Safety
  • Excavation/Trenching
  • Fall Protection
  • Forklift
  • Lockout/Tagout (LOTO)
  • Respiratory Protection
  • Silica
  • OSHA

• OSHA Course Completed

  OSHA 10

  OSHA 30

• Required Safety Training Completed

  Yes

  No

  N/A

• Date of Training

PPE

• Head

  Yes

  No

  N/A

• Eyes and Face

  Safe

  At Risk

  N/A

• Hearing

  Safe

  At Risk

  N/A

• Respiratory

  Safe

  At Risk

  N/A

• Body

  Safe

  At Risk

  N/A

Job at hand

• Prepared to perform task

  Safe

  At Risk

  N/A

• Eyes on task?

  Safe

  At Risk

  N/A

• Focused on job at hand?

  Safe

  At Risk

  N/A

• Nature of Distraction

  Select Phone/Other Handheld Device Another Employee Environment (Noise, Traffic, Weather) Other

  • Phone/Other Handheld Device
  • Another Employee
  • Environment (Noise, Traffic, Weather)
  • Other

• Access and Egress (Ascending/Descending from Machinery)

  Safe

  At Risk

  N/A

• Attention to pinch points/sharp edges?

  Safe

  At Risk

  N/A

Ergonomics

• Pushing/Pulling

  Safe

  At Risk

  N/A

• Lifting/Lowering

  Safe

  At Risk

  N/A

• Twisting

  Safe

  At Risk

  N/A

• Over exertion /Cramped

  Safe

  At Risk

  N/A

• Repetitive Motion

  Safe

  At Risk

  N/A

Procedures

• Standard/Adequate?

  Yes

  No

  N/A

• Standard/Followed?

  Yes

  No

  N/A

• Permits?

  Yes

  No

  N/A

• Known/Understood?

  Safe

  At Risk

  N/A

Tools and Equipments

• Tool selection used

  Safe

  At Risk

  N/A

• Right tool/Equipment

  Yes

  No

  N/A

• Equipment Condition

  Safe

  At Risk

  N/A

• Mobile equipment use /spotter used?

  Safe

  At Risk

  N/A

• Tool/equipment Inspection

  Safe

  At Risk

  N/A