Job Task Observation

• Document No.

• Job Task Observation

• Client / Site

• Conducted on

  Date

• Prepared by E. Majewski

• Location
  Address

• Select date

  Date

Task Observed

• Task Observed

Equipment Used

• Equipment Used

Workers

Department

Workplace

• Was the "We Care Card" filled out properly?

  Yes

  No

• Does a Policy and / or Procedure exist for this task?

  Yes

  No

• If so did the work have a copy or did you provide a copy?

  Yes

  No

• If no procedure for the task, should one be developed?

  Yes

  No

• Was the Personal protective equipment (PPE) adequate and in conformity with all applicable Policies and Procedures?

  Yes

  No

• Was it worn correctly?

  Yes

  No

• Was a Pre-Op completed and filled out correctly?

  Yes

  No

• Were all practices in conformity with all applicable standards for this task?

  Yes

  No

• Did the worker perform the task with adequate skills?

  Yes

  No

  N/A

• If " NO", What is the recommended follow-up action?

  Training

  Coaching

• Has a risk assessment been done for this task?

  Yes

  No

• If " NO", should one be completed.?

  Yes

  No

• Is the worker following all Golden Rules applicable to the task?

  Yes

  No

• Did the worker have any concerns?

  Yes

  No

• Hazards identified and addressed?

  Yes

  No

• If "NO", Explain.

• Is another observation required soon?

  Yes

  No

• Add signature

  Sign

• Describe all conditions or practices that could lead to an accident or material damage.

• Employee:

• Select date

  Date

• Supervisor:

• Signature

  Sign

• Select date

  Date

• General Foreman:

• Signature

  Sign

• Select date

  Date