Information
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Document No.
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Site / Area
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Conducted on
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Conducted by
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Location
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Personnel Consulted
Conversation & Observations
Objective
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1. To demonstrate a commitment to safety
2. Engage staff and management together
3. Provide two way feedback on safety
4. Create a focus and culture on safety
Instructions
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1. Start a conversation about safety with an employee using the examples of questions provided below (if required)
2. List any positive or negative findings based on the conversation
3. Conduct a site walk around checking items listed in the observations table
4. Add corrective actions identified into the action plan
5. Provide a copy to the manager of the area / site visited as well as the safety team
Conversational Prompts
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• Tell me about your job? How does it work?
• What are the most common hazards for this job?
• Do you have a site safety / operational plan / SWPs in place?
• What are the most significant hazards you have at this site / for this activity?
• What are the particular controls you have in place and are they effective?
• Is there a safer way of doing this activity?
• How are you trained in SWPs? Does this help you to work safely?
• What incidents / near misses have you had lately and what corrective actions have been taken?
• Is the plant right for the task being done?
• What training have you had for this particular task?
• Are you aware of the latest safety alert / KeepSAFE?
• Are there specific competencies for any plant being operated?
• What additional things can FCNSW / I do to ensure people / you are working safely?
• What was the last incident you heard about at this location.... outside this location?
Positive Findings
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Enter positive findings
Negative Findings
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Enter negative findings
Observations (If No, enter action required)
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Site induction given on arrival and persons wearing correct PPE?
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Chemicals appropriately labelled & SDS available?
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Signage in place and housekeeping in good order?
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Unsafe equipment / plant tagged out?
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Vehicles adhere to site / road speed limits?
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Vehicles kept / maintained in good condition?
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Worker not in the line of fire? (heavy equipment in area, separation distances etc)
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Persons operating mobile plant are appropriately licensed / competencies available?
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Contractors operating according to site safety plan? Is it specific?
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Lifting equipment available and in good working order?
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Emergency exits / designated walkways clear from obstructions?
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Any other hazards / observations that you have identified?
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Enter additional actions here
Action Plan
Authorisation
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Please Sign