Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Task / Activity Description

  • Persons Involved

  • Is there a Safe Working Procedure/Work Instruction available for the observed task being followed?

  • For the observed task, was a ZERO-IN risk assessment conducted ?

  • For an observed high risk task, was a Pre-Task Risk Assessment (PTRA) conducted?

  • For an observed non-routine task, was a Pre-Task Risk Assessment (PTRA) conducted?

  • Have the correct tools/equipment been identified and available at the point of work?

  • Is the correct/suitable PPE identified and used by all involved?

  • Do all employees involved in a task understand the risk control measures identified for the task? Interview personnel.

  • Is everyone involved in or affected by the job been informed of the job, prior to commencing?

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