Genie - ACE (Acting, Coaching, Engaging)

• Prepared by

• Conducted on

  Date

• Task

• Location
  Address

• Instructions:
   Introduce yourself to the TM(s) and explain the Genie – ACE program.
   Ask TM(s) one or more questions found below. Provide feedback below
   Complete the observation looking for Life Saving Behaviors
   Document (+/desired) behavior and (-/at risk) behaviors
   Recognize TM(s) who are following the Life Saving Behaviors
  

Team Member Engagement Questions

• What motivates you to work safely?

• How could you get hurt from doing your job?

• How could you do your job more safely?

• When have you paused for safety in your area?

• How can you improve safety in your area?

• How do you protect yourself and others from hazards?

• What are the hazards of the job you are doing?

• Have you completed your daily inspection? (Hoist, PIT, Tool)

Life Saving Behaviors

• Use the questions below to determine if a JOB PAUSE is needed

Work at Height Activity

• 

• If TM’s are working at height what controls are in place to prevent them from falling; conversely, do you see work at height (greater than 4 ft. or 1.2 m) that is not controlled?

  Yes

  No

  N/A

• Did you Pause The Job?

  Yes

  No

  N/A

Lifting Activities

• 

• In production or routine lifts, look for the lift plan or lift SOP and verify the procedures. In the field or for non-standard lifts – ask for the rigging plan, which may be hand written with diagrams or a checklist

  Compliant

  Non-Compliant

  N/A

• Did you Pause The Job?

  Yes

  No

  N/A

Danger zone risks

• 

• Are TM’s standing free and clear of the danger zone from unstable or suspended load?

  Yes

  No

  N/A

• Did you Pause The Job?

  Yes

  No

  N/A

Lock Out & Tag Out risks

• 

• If you observe a LOTO in progress ask the TM to walk you through how they identify when LOTO is required and the process they go through to ensure they have locked out and tagged all energy sources

  Compliant

  Non-Compliant

  N/A

• Did you Pause the Job?

  Yes

  No

  N/A

Machine Safety risks

• 

• If machinery is in use speak with the TM about the required interlocks and guards they check before operating equipment, are they functioning?

  Yes

  No

  N/A

• Did you Pause the Job

  Yes

  No

  N/A

PIT risks

• 

• Observe fork lifts in use and look to see what actions TM’s take to work safely around vehicles. Do you have concerns?

  Yes

  No

  N/A

• Did you Pause the Job

  Yes

  No

  N/A

Confined Spaces risks

• 

• Ask if they have confined spaces in their workspace and the checks they make before entry into the confined space, are they working safely?

  Yes

  No

  N/A

• Did you Pause the Job?

  Yes

  No

  N/A

Seat Belt risks

• 

• Observe to see if seat belts are being worn when operating vehicles?

  Yes

  No

  N/A

• Did you Pause the Job?

  Yes

  No

  N/A

• 

• Is there anything else you see that you believe should be paused and reviewed before proceeding?

  Yes

  No

  N/A

• Explain:

Discussion with TM

• After the observation, spend a few minutes talking with the Team Member about the following: What can we (your leadership) do to make things safer and better? How they think it is best to reinforce the LSB’S?

PPE

• For any UNSAFE actions, add which Tier board this item needs to be escalated to in the comments section

• PPE Man Available and Correct?

  Safe

  Unsafe

  N/A

• Comments:

• Safety Glasses Worn and Worn Correctly?

  Safe

  Unsafe

  N/A

• Comments:

• Steel Toe Shoes Worn?

  Safe

  Unsafe

  N/A

• Comments:

• Hearing Protection Worn and Worn Correctly?

  Safe

  Unsafe

  N/A

• Comments:

• Proper Gloves Worn for Task?

  Safe

  Unsafe

  N/A

• Comments:

• Weld PPE Worn and in Good Condition?

  Safe

  Unsafe

  N/A

• Comments:

• Other Comments:

Positions of Team Members

• Struck By (moving object)

  Safe

  Unsafe

  N/A

• Comments:

• Struck Against (running into object)

  Safe

  Unsafe

  N/A

• Comments:

• Pinch/Caught Hazard (body part between two parts)

  Safe

  Unsafe

  N/A

• Comments:

• Fall Hazard ( working at > 4' with no fall protection)

  Safe

  Unsafe

  N/A

• Comments:

• Ergonomic Considerations

  

• Repetitive Motion (ergonomic concern)a

  Safe

  Unsafe

  N/A

• Comments:

  Yes

  No

  N/A

• Ergonomic Considerations

  

• Awkward Position (ergonomic concern)

  Safe

  Unsafe

  N/A

• Comments:

• Other comments:

Tools and Equipment

• Tools in safe condition

  Safe

  Unsafe

  N/A

• Comments:

• Tools used in safe manner

  Safe

  Unsafe

  N/A

• Comments:

• Right tool for the job

  Safe

  Unsafe

  N/A

• Comments:

• TM authorized to use tool

  Safe

  Unsafe

  N/A

• Comments:

• Other comments:

Unsafe Conditions

• Slip/Trip Hazards (hoses, liquids, raised guides)

  Safe

  Unsafe

  N/A

• Comments:

• Machine guarding (in place, adequate)

  Safe

  Unsafe

  N/A

• Comments:

• Cranes / Hoist (daily inspections, use properly)

  Safe

  Unsafe

  N/A

• Comments:

• Carts (tip hazard, maintained, trip hazard)

  Safe

  Unsafe

  N/A

• Comments

• Other Comments: