Information
Personnel Section
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Associate Name:
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ID Number:
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Employee Status:
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Prepared by
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Observation Date / Start Time:
Reason for Observation
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New Employee
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New Job Assignment
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Job Performance Review
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Other (Describe)
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Other reason for observation
Skill in Methods
Method Grades
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Not Observed (NOB) = activity not observed
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)
Method Steps
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1. Obtains assignment from Lead / Ops mgr then starts task without delay
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2. Operator travels to dock or pick location in the most direct route with forks at proper travel height
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3. Confirms slot location is correct and adjusts forks to needed height, identifies correct pallet lot tag
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4. Obtains pallet in a safe and efficient manner confirming lot number is correct<br>
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5. Documents case count on LTO check sheet, and proceeds to staging area in safe manner
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6. Maneuvers pallets from dock to pallet inverter, stretch wrapper, and loads on truck
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7. Document each pallet count as they are loaded on the truck
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8. Keep all excess wood pallets and dividers off of load out dock
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9. Honk horn coming out of trailers and in and out of doors
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10. Proceeds to blast / slot / dock location in direct route depositing pallet in safe manner
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11. Documents lot, product type, and quantity on Putaway sheet
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Stop Time:
Safety Elements
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Scoring Safety Elements
Safe (S) = Safe Behaviors
Unsafe (US) = Unsafe Behaviors
NA = Not Applicable -
1. Maintained all body parts (feet, legs, hands, and arms) inside operator compartment, when in use.
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2. Ensured MHE was at complete stop, before dismounting.
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3. Maintained lift at proper distance from pallet, during picks / pallet wrapping, to avoid trip hazard.
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4. Demonstrated proper lifting techniques.
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5. Demonstrated proper driving techniques and sounded horn when entering doors, between cross aisles, around blind spots and exiting trailers.
Performance Estimate
Performance Grades
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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
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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
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Effort Characteristics:
Below = slow, not best effort, slow motion
Meet = steady, enthusiastic, average
Exceed = fast, focused, sometimes too much -
Time Utilization
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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
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Performance Estimate =
- 20
- 10
- 0
- -10
- -20
- -30
Coachable Moment
Review Coachable Behavior with associate
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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:
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Coachable category:
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Coachable Behavior (Additional notes about employee's performance during this observation)
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Follow-Up required:
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Planned date for Follow-up:
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Associate Signature:
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Supervisor Signature:
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Quality Audit by Managers
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CMO Quality Feedback
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Manager Signature:
