Information

Personnel Section

  • Facility Name:

  • Associate (Last name, First name)

  • Employee Status:

  • ID Number:

  • Conducted by:

  • Document No.

Reason for Observation

  • New Employee (Temp / New Hire in probation period)

  • Select last completed week of job probation period (1-12).

  • New Job Assignment

  • Job Performance Review

  • Was associate a low performer last week?

  • How many weeks as low performer, in this task?

  • Other (Describe)

  • Other reason for observation

Skill in Methods

Method Grades

  • Not Applicable (N/A)
    Below (B) = somewhat clumsy, fumbles, hesitations (loses time)
    Meet (M) = steady, proficient, average (neither gains or loses time)
    Exceed (E) = safely reduces motion, quick, smooth (gains time)

  • Observed Activity:

  • Start Time:

Method Steps

  • 1. Associate will obtain an empty pallet to begin the slatting process.

  • 2. The empty pallet is placed close enough to the product already palletized, to avoid over extending.

  • 3. Associate will begin transferring cases from the full pallet to the empty pallet (using properly lifting technique).

  • 4. Once a full layer is transferred, a spreader (slat) will be applied.

  • 5. Repeat above steps, applying slats between each restacked layer, until the pallet is complete.

  • 6. Continue restack / slat process until all pallets are complete.

  • 7. Load pallets in target blast cell, ensure proper pallet placement.

  • 8. Notify supevisor once the process is complete, for next assignment.

  • Stop Time:

  • Delay Minutes (observed)

Safety Elements

  • Safety remarks required

  • Scoring Safety Elements
    Below (B) = does not comply and/or understand
    Meet (M) = understands and performs most of the time
    Exceed (E) = understands and performs all the time

  • 1.

  • 2.

  • 3.

Performance Estimate

Performance Grades

  • Scoring Performance Estimate
    Below (B) = less than 0 Meet (M) = greater than 0 but less than +10 Exceed (E) = greater than +10

  • Skills in Methods

  • Method Characteristics:
    Below = somewhat clumsy, adds motion, fumbles, hesitation, errors
    Meet = follows methods, proficient, consistent, steady, average
    Exceed = precise and smooth, quick and sure, reduces motions, smart, perfection

  • Effort Level

  • Effort Characteristics:
    Below = slow, not best effort, slow motion
    Meet = steady, enthusiastic, average
    Exceed = fast, focused, sometimes too much

  • Time Utilization

  • Utilization Characteristics:
    Below = does not try to avoid delay, exceeds delay allowances, stops working to talk
    Meet = minimizes delay by following the methods, continues working while talking, sometimes successful at avoiding delay
    Exceed = eliminates delay by eliminating motion, always works - never talks, always successful at avoiding delay

Overall Performance Score

  • Performance Estimate =

  • Actual Performance from LMS

Coachable Moment

Review Coachable Behavior with associate

  • 5-Step Coaching Model
    1) Convey Positive Intent
    2) Describe behavior and actions observed
    3) State impact of desired coachable behavior(s)
    4) Ask associate to respond
    5) Focus discussion on solution

  • Was a Coachable Moment Observed:

  • Coachable category:

  • Coachable Behavior (Additional notes about employee's performance during this observation)

  • Follow-Up required:

  • Planned date for Follow-up:

  • Associate Signature:

  • Supervisor Signature:

  • Quality Audit by Manager

  • CMO Quality Feedback

  • Manager Signature:

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.