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. Receive assignment from Supervisor / Ops desk.

  • 2. Prepare trailer for unloading. Verify trailer temps.

  • 3. Open dock door and apply dock plate. Use proper trailer restraints.

  • 4. Unload multiple pallets, not exceeding site-approved batch size, to nearest staging area.

  • 5. Check product temp (tail, middle and end of trailer).

  • 6. Check product condition for damage, product and date code errors.

  • 7. Set aside any pallets that can not immediately be made putaway ready.

  • 8. Ensure inbound pallets are properly wrapped for putaway.

  • 9. Verify product received to what paperwork is showing to be received.

  • 10. Correct inbound pallet discrepancies, documenting extra work on ESI sheets, as applicable.

  • 11. When un-loading is complete, retract dock plate and close dock door.

  • 12. Complete and return inbound paperwork.

  • 13. Report inbound load completion to Supervisor / Ops desk.

  • 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.