Audit

LOCATION:

DATE & TIME OF OBSERVATION:

TYPE OF WORK BEING OBSERVED:

NUMBER OF PEOPLE BEING OBSERVED:
CRAFT BEING OBSERVED

EQUIPMENT BEING WORKED ON:

WAS A PRE-JOB BRIEFING CONDUCTED?

WAS "EYES ON PATH" USED DURING YOUR OBSERVATION?

WAS "EYES ON HANDS" USED DURING YOUR OBSERVATION?

CATEGORY A - Personal Protective Equipment

Personal work clothing is in good condition. A.1

Personal Protective Equipment is correct for the hazard. A.2

PPE is being used properly and is in good condition. A.3

CATEGORY B - General Awareness

Worker is aware of, and observant of, nearby hazards. B.1

Worker is aware of heavy equipment and demonstrates effective practices to remain clear. B.2

Workers are focused on the task and are free of distraction. B.3

CATEGORY C - Work Practices

Scrap material is controlled to prevent accumulations on walking and working surfaces. C.1

Material is staged for efficiency and keeping walking and working areas clear. C.2

Tools in use are appropriate for the task and are used correctly. C.3

Housekeeping is maintained to provide organized and clean work areas. C.4

CATEGORY D - Procedures and Best Practices

Pick and Carry of material, D.1

Load is minimized. D.2

Load handling pathway is scouted. D.3

A spotter is used when load handler can not see pathway. D.4

Signaling of loads is clear and visible. D.5

Radio signaling is clear and concise when used. D.6

CATEGORY E - Communication

All craft understand Pre-task. E.1

All craft are provided and accept clear direction. E.2

Workers are aware of adjacent work and have briefed others on their work. E.3

Two-way communication is used to ensure message is correctly received. E.4

Teamwork is evident. E.5

Workers accept coaching. E.6

All workers look out for each other as their Brother's Keeper. E.7

Observation Feedback
Observation Category

Feedback Provided

Observation Category

Feedback Provided

Observation Category

Feedback Provided

Pre-Incident Learning Questions

How can someone get hurt doing this task? How have we avoided that?

Have you experienced or heard of recent close calls? What happened? What did we do about it?

What is your biggest safety concern on this job?

5/28/2013 Frank Deller Failure to feedback is acceptance of the behavior.

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.