Information

  • Empresa

  • Fecha de visita

  • Dependencia

  • Direccion
  • Observación

Workplace

  • Housekeeping

  • Workspace

  • Prevention and protection measures

  • Is hazards and requirements information available?

Ergonomy

  • Push and pull

  • Lifting and lowering

  • Torsion

  • Crouch/snuggle

  • Overwork

  • Repetitive actions

Procedures

  • Are the procedures known?

  • Are the procedures followed correctly?

  • Are safety standards satisfied?

Working equipement

  • Is working equipement in good state?

  • Is working equipement correctly used?

PPE

  • Hands

  • Head

  • Eyes and face

  • Ears

  • Nose and mouth

  • Feet

  • Body

Personal evaluation

  • Is the worker aware of the risks due the activities he's doing and to' the place where those activities take place? Does he prevent them?

Recomanded actions

  • undefined

Signatures of participants

  • Worker observed

  • Person involved

  • Observer

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.