Title Page

  • Site conducted

  • Conducted on

  • What was the unsafe act that has been stopped

  • Please summarise the unsafe act that has been stopped

  • Person stopping the unsafe act

STAR Assessment


  • Is there a risk assessment available for this task?

  • Please complete a suitable risk assessment

  • Please review the risk assessment

  • Who was involved in the unsafe act (use initials only)?

  • Why was the task stopped?

  • Provide information regarding the operation and why it was considered unsafe.

  • What unsafe behaviours were witnessed?

  • Why was the work area unsafe? Please provide details

  • Has the equipment been inspected prior to use?

  • What makes the equipment unsafe? Please provide details

  • What materials are being used that are unsafe?


  • How can this act be made safe?

  • What aspect of the operation should be improved?

  • How can the behavior be improved?

  • Please describe what other action is required to improve behaviour

  • How can the equipment be improved?

  • Please describe other improvement to the equipment

  • How can the work area be improved?

  • Describe what other improvement is required in the work area to make the act safe

  • Can another material be used instead?

  • What material can be used instead?


  • Have the improvements considered above been communicated to the individuals involved in the unsafe act?

  • Please sign to confirm that you have received the improvements communication

  • Can the task now be completed safely?

  • Continue to THINK how the task can be made safe - If it is not possible do not continue.


  • Was this task made safer from the improvements detailed above?

  • Can this improvement be a permanent corrective action for this type of task?

  • Please raise actions on how these actions can become permanent, for example , retraining, process improvements, risk assessment review etc

Sign off

  • Full name

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