CG - BBSO

• Document No.

• Activity being observed

• Observer's name

• Conducted on

  Date

• Name of person being observed

• Location
  Address

Behavior Types

PPE

• Correct PPE for the task?

  Safe

  At Risk

  Not Observed

• Is PPE in good condition?

  Safe

  At Risk

  Not Observed

• PPE proper fit and used correctly?

  Safe

  At Risk

  Not Observed

Work Behaviour

• Good personal hygiene habits?

  Safe

  At Risk

  Not Observed

• Good food handling techniques?

  Safe

  At Risk

  Not Observed

• Focused on job at hand and not distracted?

  Safe

  At Risk

  Not Observed

• Shows care for the safety of other colleagues?

  Safe

  At Risk

  Not Observed

• Prompt actions in removing a hazard?

  Safe

  At Risk

  Not Observed

• Communicates with other workers if required?

  Safe

  At Risk

  Not Observed

Tools and Equipment

• Correct tool and equipment for task?

  Safe

  At Risk

  Not Observed

• Proper use of tools and equipment?

  Safe

  At Risk

  Not Observed

• Tools and equipment in good order?

  Safe

  At Risk

  Not Observed

• Tools and equipment cleaned and sanitized?

  Safe

  At Risk

  Not Observed

• Correct storage of tool and equipment?

  Safe

  At Risk

  Not Observed

Manual Handling

• Trolleys utilized wherever possible?

  Safe

  At Risk

  Not Observed

• Proper lifting techniques?

  Safe

  At Risk

  Not Observed

• Does the task involve frequent twisting and bending?

  Safe

  At Risk

  Not Observed

• Asked for assistance if unable to perform work safely?

  Safe

  At Risk

  Not Observed

Reason for At Risk Behaviour (please tick)

• Disagree with Safe Practices?

• Personal Choice / Shortcuts?

• Facilities / Equipment: Proper tools or safety equipment not available?

• Unaware of safe practices for specific job / Doesn’t think practice applies to the job?

• Lost focus. Distracted from current task?

• Others (Explain below)

• Note explanation

Comments / Corrective Actions Taken

• Note comments / corrective actions taken