Information
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Your Name:
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Task/Job Observed:
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Date & Time scan was done.
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Let the operator know you will be observing him/her performing work for approximately 5 minutes and will then provide feedback.
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Please include details on all At Risk findings in spaces below
Behavior Based Observations
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1. Identified 1-3 items the operator is doing safetly. (List Below)
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2. Is the operator wearing all required PPE correctly and mule card is completed for current shift?
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3. Is the operator Focused on task?
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4. Backing up less than 5 steps before moving forward?
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5. Hauling a maximum of 2 equilibrators at a time?
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6. Looking in direction if travel when using mule?
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7. Are operators traveling with forks trailing, except when positioning load or traveling up ramp?
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8. Is the operator using the appropriate speed for the task and location and maintaining a safe distance from others?
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9. Is the operator yielding to and making eye contact with pedestrians and other operators?
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10. Is the operator using horn while going through doors, around corners,behind people, etc.?
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11. No use of any electronic devices while operating mule?
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12. Is the operator reporting and removing congestion and debris in path?
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13. Is the operator maintaining a safe clearance from obstacles?
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14. Is the operator using two hands to operate the mule when positioning load?
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15. Are both hands inside guarded handle vs. grabbing on the outside?
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16. Is the operator parking the mule in a safe, level area with forks lowered?
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17. Does the operator have a brown mule sticker on their helmet? Is it current?
