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Behavior Observation Checklist - Maintenance

Florence - Maintenance Dept For each safety observation pinpoint, record the total number of associates you observed performing the requirement correctly (Safe) and the total observed not performing the requirement correctly (At-Risk). Please summarize feedback provided (most important step) to promote safe behavior and correct at-risk behaviors observed.

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Information

Behavior Observation Checklist - Maint. Dept
Conducted on
Audit Conducted By :
Select Location
Select Shift

Power tools do not have frayed chords and safety features working.
Safe
At- Risk
N/A
Machine-specific LOTO procedures are referenced and followed during LOTO situations
Safe
At-Risk
N/A
Fall protection harness and lanyards are used in man-lifts, scissor lifts and boom lifts.
Safe
At-Risk
N/A
Hearing protection is worn properly in production areas where required ?
Safe
At-Risk
N/A
Team lifting is performed when lifting items over 40lbs.
Safe
At-Risk
N/A
Type in other observations, hazards identified or comments:

Satinder Pabla

Behavior Observation Checklist - Maintenance

Use this Template

Print as PDF

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