Information
STARR - Safety Training and Risk Recognition
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Client / Site
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Add location
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Conducted on
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Task
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Personnel
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Observer
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Supervisor
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Document No.
ACTIONS OF PEOPLE
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Adjusted PPE?
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Changing positions?
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Rearranging job?
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Stopping Job?
PERSONAL PROTECTiVE EQUIPMENT
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Head?
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Eyes?
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Ears?
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Respiratory systems?
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Arms and hands?
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Trunk?
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Legs and feet
EQUIPMENT USE
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Right for the job?
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Used correctly ?
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In a safe condition?
BODY POSITION AND USE (looking for possible outcomes)
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Struck by objects?
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Striking against objects?
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Caught in, on or in between objects?
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Overexertion?
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Awkward position / static posture?
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Falling or tripping?
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Contacting electrical current?
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Contacting temperature extremes?
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Inhaling hazardous substance?
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Swallowing hazardous substance?
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Absorbing hazardous substance?
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Repetitive motion?
ADHERENCE TO PROCEDURES (JHA Requirements)
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Work procedure and JHA adequate?
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Work procedure and JHA being followed?
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Work procedures and JHA understood by all personnel?
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Housekeeping / 5's standards adequate?
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Housekeeping / 5's standards understood by all personnel?
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Working conditions?
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Was Take 5 performed?
SAFE ACTS OBSERVED (SAFE)
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Additional actions taken to encourage continued safe performance.
ADDITIONAL UNSAFE ACTS OBSERVED (AT RISK)
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All corrective actions must be allocated to the person observed or immediate supervisor with a completion date.
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UNSAFE ACT 1
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ACTION BY:
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DUE DATE
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UNSAFE ACT 2
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ACTION BY:
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DUE DATE
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UNSAFE ACT 3
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ACTION BY:
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DUE DATE
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UNSAFE ACT 4
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ACTION BY:
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DUE DATE
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UNSAFE ACT 5
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ACTION BY:
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DUE DATE
