Job Task Observation

• Document No.

• Task Observed

• Employee being Observed

• Department

• Complex/Workplace

• Conducted on

  Date

• Prepared by

• Type of Observation

  Initial

  Follow Up

• Reason for Observation

  Select Critical Task New Worker Incident Repeater Good Performer Needs Coaching Other

  • Critical Task
  • New Worker
  • Incident Repeater
  • Good Performer
  • Needs Coaching
  • Other

• Task Description

• Was WE CARE Card filled out properly?

  Yes

  No

  N/A

• Does a Policy or Procedure exist for this task?

  Yes

  No

  N/A

• If Yes, Did you provide a copy to the worker?

  Yes

  No

  N/A

• If No, should one be developed?

  Yes

  No

  N/A

• Was the worker wearing all the required PPE for performing the task?

  Yes

  No

  N/A

• Did the worker follow all the Golden Rules applicable for the task?

  Yes

  No

  N/A

• What part(s) of the task did the worker perform well and up to standard?

• What part(s) of the task does the worker need to improve on?

• What is the recommended follow up to Improve the workers skills?

  Training

  Job Coaching

• Is there a better or safer way to perform the task? If yes, explain.

  Yes

  No

  N/A

• Is the policy or procedure adequate for the task performed? If no explain.

  Yes

  No

  N/A

• Did the worker have any concerns? If yes please explain.

  Yes

  No

  N/A

• Were any hazards identified and addressed? If not addressed explain.

  Yes

  No

  N/A

• Is a follow up observation needed within the next 2 weeks or sooner? If yes explain.

  Yes

  No

  N/A

• List any follow up actions required as a result of this Job Task Observation:

APPROVALS

• Employees Signature

  Sign

• Supervisor Signature

  Sign

• General Foreman/Dept. Head Signature

  Sign