Information

Personnel Section

  • Employee Name

  • Employee Status

  • Prepared By

  • Observation Date / Start Time:

  • Reason for CMO

  • Details

Skill in Methods

Method Grades

  • Below = unsure, fumbles, hesitations (loses time)
    Meet = steady, proficient, average (neither gains or loses time)
    Exceed = safe, confident, quick, smooth (gains time)
    Not observed = activity not observed

Method Steps & Safety Elements

  • Did the associate pick all full pallets safely?

  • Has the associate checked pallet label is correct full pallet to be picked?

  • Did the associate check the full pallet quantities are the same as ordered?

  • Did the associate pick the part pallets safely?

  • Have the part pallet picks been returned to racking or appropriate areas?

  • Did the associate let down the replenishments safely?

  • Were the replenishments checked to be the correct pallets and quantities?

  • Did the associate pick correct quantities from pick bins?

  • During the entire order, did the associate use proper carton handling techniques?

  • Have the pallets and cartons been stacked in good order?

  • Did the associate cross off completed picks from the order?

  • Is the completed order wrapped?

  • Did associate stage the order in appropriate area?

  • Is the order labelled correctly?

  • Is the number of pallets and other information completed on picking docket?

  • Has the order been written up on outbound manifest?

  • Has the completed picking docket been placed in tray?

  • Stop Time:

Safety Engagement

Safety Engagement

  • Safety Engagement Details

  • Details / Comments

Perfomance

Performance

  • Skill in methods
    Below = unsure, fumbles, hesitations (loses time)
    Meet = steady, proficient, average (neither gains or loses time)
    Exceed = safe, confident, quick, smooth (gains time)

  • Skills in methods

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

  • Effort Level

  • 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

  • Time Utilization

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 moment details

Employee ideas or suggestions

  • Has the employee got any ideas or suggestions for improvements to the site or the business

  • Please provide comments

  • Associate Signature:

  • Supervisor 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.