Information

STARR - Safety Training and Risk Recognition

  • Client / Site

  • Add location
  • Conducted on

  • Task

  • Personnel

  • Observer

  • Supervisor

  • Document No.

ACTIONS OF PEOPLE

  • Adjusted PPE?

  • Changing positions?

  • Rearranging job?

  • Stopping Job?

PERSONAL PROTECTiVE EQUIPMENT

  • Head?

  • Eyes?

  • Ears?

  • Respiratory systems?

  • Arms and hands?

  • Trunk?

  • Legs and feet

EQUIPMENT USE

  • Right for the job?

  • Used correctly ?

  • In a safe condition?

BODY POSITION AND USE (looking for possible outcomes)

  • Struck by objects?

  • Striking against objects?

  • Caught in, on or in between objects?

  • Overexertion?

  • Awkward position / static posture?

  • Falling or tripping?

  • Contacting electrical current?

  • Contacting temperature extremes?

  • Inhaling hazardous substance?

  • Swallowing hazardous substance?

  • Absorbing hazardous substance?

  • Repetitive motion?

ADHERENCE TO PROCEDURES (JHA Requirements)

  • Work procedure and JHA adequate?

  • Work procedure and JHA being followed?

  • Work procedures and JHA understood by all personnel?

  • Housekeeping / 5's standards adequate?

  • Housekeeping / 5's standards understood by all personnel?

  • Working conditions?

  • Was Take 5 performed?

SAFE ACTS OBSERVED (SAFE)

  • Additional actions taken to encourage continued safe performance.

ADDITIONAL UNSAFE ACTS OBSERVED (AT RISK)

  • All corrective actions must be allocated to the person observed or immediate supervisor with a completion date.

  • UNSAFE ACT 1

  • ACTION BY:

  • DUE DATE

  • UNSAFE ACT 2

  • ACTION BY:

  • DUE DATE

  • UNSAFE ACT 3

  • ACTION BY:

  • DUE DATE

  • UNSAFE ACT 4

  • ACTION BY:

  • DUE DATE

  • UNSAFE ACT 5

  • ACTION BY:

  • DUE DATE

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.