Title Page

  • Observer

  • Conducted on

  • Location
  • Observee

Observations

  • Has the JHA and Tailboard been properly completed prior to any work starting?

  • Are there any high energy hazards or STKY that was missed?

  • List the high energy hazards or STKY that was missed and controls for them.

  • Are the controls listed for each high energy hazard or STKY?

  • Is the correct PPE for the task being utilized?

  • What PPE was coached on?

  • Is the STCTG procedure being used for this task?

  • Is all documentation filled out correctly?

  • What was coached on?

  • Is there adequate traffic control for this task?

  • What was coached on?

  • Is the DZB being utilized to its fullest potential?

  • What was coached on?

  • Are the crew members actively coaching one another?

  • What was being coached on?

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.