DCC Leadership Conversations & Observation Form

• Council Group

• Sub Group

• Conducted on

  Date

• Leadership walk conducted by

• Interviewee Name

• Instructions:
  1. Please complete each question, they are designed to start a conversation around Health and Safety with staff.
  2. To add further detail or photo, tap on the paperclip icon on the right of each question.
  3. Complete the form entirely.
  4. Share your report by exporting as a PDF or by `share report'.
  5. Load your completed form into Vault or send to your assistant to load.
  6. Ensure any issues are followed up and updated as required.

Systems/Procedures

• For ELT member Were you appropriately inducted to the site?

  Yes

  No

  N/A

• Request if there are any hazards that you should be made aware of whilst visiting the site?

Safety and Culture Conversations

• Ask the worker "tell me about the work being undertaken on your site. What hazards have the highest risk; those that could harm you or others, or worse?" Was there a clear understanding of the hazards and associated risks?<br>

  Yes

  No

  N/A

• Make a judgement on the level of risk this may cause e.g. is there potential for immediate harm, in which case you might stop the work and contact the manager until you are satisfied that it is safe to continue or if it is low risk you might think about some future actions e.g team leader to provide training.

• What controls are you using to manage the hazards? Are those controls in place?

  Yes

  No

  N/A

• Do you believe you have received the appropriate health and safety training to perform your role?

  Yes

  No

  N/A

• If not, what more do you require?

• Can you show me the personal protective equipment you are required to wear, does it protect you? Do you have any other thoughts, good or bad around the use of PPE?

  Safe

  At Risk

  N/A

• As an employee do you have a clear understanding of your health and safety role and responsibilities? Prompt below

  Select Comply with H&S policies and procedures Ensure their own safety and that of others Report all incidents, accidents, near misses or new hazards Stop any unsafe practices or advise manager

  • Comply with H&S policies and procedures
  • Ensure their own safety and that of others
  • Report all incidents, accidents, near misses or new hazards
  • Stop any unsafe practices or advise manager

• If you could do one thing to improve health and safety here, what would that be?

• Do you know who your health and safety committee representative is?

  Yes

  No

  N/A

• AQUATIC SERVICES - Megan Ferguson
  ARA TOI - Debbie Lancaster-Gordon
  COMMUNITY & PLANNING GROUP - Lily Burrows
  CORPORATE SERVICES - Paul Hayton
  ENTERPRISE DUNEDIN - Ming Kerr
  PARS - Dani Flatt
  PROPERTY SERVICES - Hamish Black
  REGULATORY SERVICES / CSA - Jane Libeau
  TRANSPORT SERVICES - Simon Chu
  3 WATERS - Fiona Turner
  UNION REPRESENTATIVE - Nigel Wilkinson
  

• Have you ever logged a near miss or new hazard in Vault?

  Yes

  No

  N/A

• Do you know what the outcome was and what corrective actions (if any) were implemented?

  Yes

  No

  N/A

• Why not?

Work Environment and Conditions

• Housekeeping and layout, appears clear of obstructions, clean and tidy workspaces?

  Safe

  At Risk

  N/A

• Add a photo of the area. If it is a matter of the area being untidy, then hold a conversation with the employee. If it is unsafe, hold a conversation with the manager of the area.

• Worksite delineation, barricades and signage sited.

  Safe

  At Risk

  N/A

• Add a photo of the area. If it is a matter of the area being untidy, then hold a conversation with the employee. If it is unsafe, hold a conversation with the manager of the area.

Acknowledgement

• Please verbalise your appreciation for the level of commitment to health and safety and recognize the work they are doing and their contribution to it.

• Add signature

  Sign