Job Safety Analysis (JSA)
Job Task Being Assessed
Job description
Select job type
- Has exposure to hazardous and harmful products
- Has high accident frequency
- New established job
- Modified job due to procedure changes
- Infrequently performed jobs
- Other
List employees being observed during JSA
Tasks, Hazards and Preventive Measures
1) Break a job down into smaller tasks and observe a worker performing it
2) Click + to add a "Job Step" and fill in the relevant information
3) Identify the potential hazards for each task
4) Determine preventive measures and controls to overcome these hazards
Job Step
Enter job step description
Potential risk or hazard identified while task is being performed (select all that apply)
- Chemical (Toxic, Flammable, Corrosive)
- Explosion (Chemical Reaction, Over Pressurization)
- Electrical (Shock, Short Circuit, Fire, Static, Loss of Power)
- Ergonomics (Strain, Sprains, Human Error)
- Excavation (Collapse)
- Fall (Slip, Trip)
- Fire
- Mechanical (Mechanical Failure, Stuck between objects)
- Noise
- Radiation (Alpha, Beta, Gamma, X-rays)
- Struck by Objects
- Extreme Temperature
- Visibility (lack of lighting, Obstructed vision)
- Weather
- Other
Rate risk/ hazard before control measures
Take a photo of step/ activity (Optional)
Hazard Control Measures
- Engineering Controls
- Administrative Controls
- Personal Protective Equipment
- Other
Explanation of control measures
Recommendation from Health and Safety Committee
Recommendations
Completion
Full Name and Signature of Inspector
Full Name and Signature of Health and Safety Committee Member
