Enter date and time of this review.

For any issues identified during this review, provide comments below the question, including any actions taken already.

If a JSA was used in the Pre-task briefing, did it adequately cover all of the hazards and control measures?

If a JSA was not used in the Pre-task briefing, did the Pre-task briefing checklist cover all of the hazards and control measures?

If a JSA was not used in the Pre-task briefing, should a JSA be developed for this job?

Was the task accomplished with expected results?

Were there any unexpected occurrences during performance of the job?

Are there recommended changes to the work that could have improved the safety or efficiency of the work, i.e. PPE, work environment, tools, materials, equipment, etc.?

Was planning and scheduling optimized to reduce the potential for human error?

Was material on hand and staged prior to beginning job.

Did supervision provide the needed support and appropriate guidance when necessary?

Did you notice any human factor issues, improper or missing labels, or any significant physical hindrances to the performance of the work?

Did all workers have proper training needed or required to successfully and efficiently complete the the job?

Was the work area clean and housekeeping adequate before work began?

Is additional follow up required from this POST-JOB Review.
( if YES, then the Foreman/Supervisor/Lead Performer is responsible to provide this feedback to the responsible group for action. )

Did all involved with the work understand their individual responsibilities?





3/12/2013 Frank Deller

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.