Part A - Task being observed

Observation Team Members

Location

Time of observation

Safe Act Observation Checklist

Risk Assessment

  • Risk assessment required and completed?

  • Risk assessment followed if required?

  • Required permits in place?

Housekeeping

  • Passageways clear of fire hazards?

  • Area free from possible trips / slip hazards?

  • Area free of rubbish?

Driving

  • Seat belts worn?

  • Driving regulations / condition compliance?

  • Correct license / permit?

  • Pre-start check / vehicle condition?

Tools & Equipment

  • Right Tools?

  • Condition & Use?

  • MSDS required & approved?

  • Correct slings used?

  • Correct harness / lanyard used?

Personal Protective Equipment

  • Hard hats / bump caps?

  • Safety glasses?

  • High visual vest / shirt?

  • Safety shoes?

  • Task specific PPE (Respirators / gloves / dust masks)?

Isolation & Tagging

  • Positive Isolation?

  • Lock-out tags in place?

People Positions

  • Barricades in place?

  • Access control?

  • Safe positions in work area (stand-off distances)?

Procedure Compliance

  • Procedure adequate?

  • Procedure understood & followed?

Environment

  • Are all waste disposed correctly?

  • Adequate dust suppression?

Part B - Corrective action

  • Unsafe condition / behaviour corrected?

Corrective Action

Part C - Personnel Involved

  • Discussions held with responsible person(s)?

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. Any ratings or scores displayed in our Public Library have not been verified by SafetyCulture for accuracy. Users of our platform may provide a rating or score that is incorrect or misleading. You should independently determine whether the template is suitable for your circumstances. You can use our Public Library to search based on criteria such as industry and subject matter. Search results are based on their relevance to your search and other criteria. We may feature checklists based on subject matters we think may be of interest to our customers.