Individuals participating in observation

  • Task being observed

  • Employee being observed

  • Employee conducting observation

Body Mechanics

  • Is your footing or position safe? List unsafe acts observed and/or corrective actions taken.

  • Is the employee using proper lifting techniques? List unsafe acts observed and/or corrective actions taken.

  • Are any pinch points present? List pinch points observed and/or corrective actions taken.

  • Is the employee overextending? List unsafe acts observed and/or corrective actions taken.

  • Is the employee pulling or twisting while working? List unsafe acts observed and/or corrective actions taken.

Tools & Equipment

  • Are the proper tools and equipment being used? List unsafe acts observed and/or corrective actions taken.

  • Are the tools and/or equipment being used in good condition? List unsafe acts observed and/or corrective actions taken.

PPE

  • Eye Protection

  • Hand protection

  • Hearing protection

  • Respirator

  • Clothing/FR Clothing

  • Fall Protection

Operating Procedures

  • Following NRTR or Standard Work?

  • Can the Employee explain the task?

  • Housekeeping conditions?

  • LO/TO required?

  • Confined space entry required?

  • Are there any changes that needs to be made to the procedure or standard work to make it current?

  • Are there any hazards present that are not included in the task steps?

  • Does the employee have any opinions about possible risks or changes?

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.