Information

Personnel Section

  • Associate Name:

  • ID Number

  • Employee Status:

  • Prepared by

  • Observation Date / Start Time:

Reason for Observation:

  • New Employee

  • New Job Assignment

  • Job Performance Review

  • Other (Describe)

  • Other reason for observation

Skill in Methods

Method Rating: 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

  • 1. Confirms assignment from Team Leader, Freezer or Chiller side?

  • 2. Associate moves to allocated lane

  • 3. Proceeds to stack cartons without delay.

  • 4. Operator verifies product is correct by looking at pick label

  • 5. Associate stacks cartons in the correct manner, ensuring heavy cartons are toward bottom of the pallet.

  • 6. Associate wraps the bottom section of the pallet prior to lowering the pallet.

  • 7. Associate can operate the scissor lift in the correct manner.

  • 9. Associate continues to stack pallet safely and securely, with no over-hanging cartons.

  • 8. Associate knows correct procedure for retrieving a new pallet.

  • 10. If product does not match pick label, associate is aware of what to do.

  • 11. Associate assists other workers when lanes are full.

  • 12. Disposes of damaged product in the correct manner.

  • 13. Associate follows correct procedure at all times.

  • Stop Time:

  • Delay Minutes (observed)

  • Do you have any suggestions to improve our business

  • Delay Minutes (observed)

Safety Elements

  • 1. We're there any PR (Positive Reinforcement) or BC (Behavioural Correction) Safety Engagements during the CMO

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

  • Do you have any suggestions/ideas on how we can improve our business.

  • 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 Managers

  • 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.