Information
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The approach by the observer is to demonstrate genuine concern for the worker's health and safety. Observers should focus on good practices as well as identifying unsatisfactory practices. Observations should be short and take no more than 15 min's.
Review past observations for the area of work, and previous actions. Use consultation and discussion to identify action and gain commitment to change from workers. -
Observee 1 Name:
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Observee 2 Name:
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Site:
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Work Area Observed:
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Conducted on
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Form completed by:
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Briefly Describe the Task being observed
TASK OBSERVATION
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Specifically What tasks / activities are being observed?
- Manual Handling
- Working with Chemicals
- Operating Machinery
- PME Operation
- Welding / Hot Work
- Working at Height
- Using Ladders
- Using EWP
- Working in Isolation
- Confined Space Work
- Using Compressed Air
- Stacking on a Machine
- Feeding a Machine
- Cleaning
- Maintenance on a Machine
- Other
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PHOTO IF REQUIRED
PERSONAL SAFETY
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Are the workers being observed working in a safe work place?<br>Consider proximity to mobile equipment, exertion and loads lifted, slip and trip hazards, exposures to heat and fumes or proximity to energy sources and task repetition
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Enter Reason
- Struck by or striking against an object
- Caught between or squashed
- Body posture, twisting turning
- Straining, pushing or pulling
- Over exertion / excessive force
- Two man lift required
- Slip / Trip / Fall hazard
- Exposure to heat / gas / fume
- Extreme temperatures
- Exposure to electrical current
- Other
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Enter details
STANDARD WORKING PROCEDURES
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Are working procedures adhered too?<br>Consider if procedures are not clear, not known , not followed , is a permit to work required, is isolation correct. Is an SOP available and being followed.
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SELECT REASON
- Procedure not known
- Procedure misunderstood
- Procedures not followed
- SOP not available (if applicable)
- Permit to work not being used (if required)
- Stop & Think not applied (if applicable)
SAFE WORK PRACTICE
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Are safe work practices being adhered too?<br>Consider body posture , twisting , turning , straining , pushing or pulling loads. Should loads be lifted by two workers , Locks and danger tags used. Isolations correct . Worker is observant and careful when walking .
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Select reason
HOUSEKEEPING
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If the rating is less than 7, enter details
- Trip hazards evident
- Debris evident
- Accumulated waste
TOOLS & EQUIPMENT
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Are tools and equipment being used, Safe?<br>Consider their condition , right tool for the job and are they used correctly
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Tools & Equipment are:
- Not right for the job
- Not being used correctly
- Not in a safe condition
PPE
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Check Eyes & Face, Ears, Respiratory, Hands, Arms, Feet & Legs, Trunk, etc
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Select Reason
- Eye protection
- Safety boots / shoes
- Noise protection
- Safety vest / clothing
- Not fit for purpose
- In poor Condition
- Other
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Enter details
OUTCOMES
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Safe acts observed
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Unsafe acts observed
SAFETY CONVERSATIONS
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SAFETY CONVERSATION Ask if the worker has carried out a Stop and Think/Dynamic Risk Assessment check today?
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DISCUSS BETWEEN THE OBSERVERS HOW THE SAFETY CONVERSATION/ DISCUSSION COULD BE IMPROVED?
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1. Check that it is safe to have a conversation.
2. Start with a positive Statement
3. Discuss consequences of any unsafe acts if observed
4. Identify safer ways to do the task
5. Gain agreement on improvements
6. Thank the employee for his participation
Sign Off
Record Actions
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List corrective action required
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List any hazards or near miss incidents to be raised
OBSERVERS SIGNATURE
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Observer
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Observee 1
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Observee 2