KGM Visual Felt Leadership

• Work Area:

• Date:

  Date

• Prepared by:

• Team Members:

OBSERVATION

• Add a note, picture or any other media to describe the observation or deviation witnessed during the visit.

• Reactions of People:

  Select Adjusted PPE Changed positions Stopped job Rearranged job Proper communication Attitude Completed isolation Showed fatigue Language Barriers Positive reaction by people

  • Adjusted PPE
  • Changed positions
  • Stopped job
  • Rearranged job
  • Proper communication
  • Attitude
  • Completed isolation
  • Showed fatigue
  • Language Barriers
  • Positive reaction by people

• PPE Deviations

  Select Eyes & Face Ears Head Hands & Arms Feet & legs Respiratory System Trunk Seat Belt Not Worn Not in good condition Not appropriate Not worn correctly No Deviations observed

  • Eyes & Face
  • Ears
  • Head
  • Hands & Arms
  • Feet & legs
  • Respiratory System
  • Trunk
  • Seat Belt Not Worn
  • Not in good condition
  • Not appropriate
  • Not worn correctly
  • No Deviations observed

• Positions of People:

  Select Can Strike Against Can be Struck By Can be Caught Between Can Fall 3 Points of Contact Not Used Exposed to Temp Extremes Exposed to Electrical Current Inhaling Absorbing Swallowing Manual Handling No unsafe position observed

  • Can Strike Against
  • Can be Struck By
  • Can be Caught Between
  • Can Fall
  • 3 Points of Contact Not Used
  • Exposed to Temp Extremes
  • Exposed to Electrical Current
  • Inhaling
  • Absorbing
  • Swallowing
  • Manual Handling
  • No unsafe position observed

• Tools & Equipment:

  Select Not Right for Task Used Incorrectly Unsafe Condition Incorrectly Tagged Pre-start Incomplete Equipment not Serviced Tools & Equipment found to be compliant

  • Not Right for Task
  • Used Incorrectly
  • Unsafe Condition
  • Incorrectly Tagged
  • Pre-start Incomplete
  • Equipment not Serviced
  • Tools & Equipment found to be compliant

• Procedures:

  Select FLRA not used/right for task JSA not used/right for task SOP not used/right for task Procedure not known Procedure not understood Procedure not followed Isolation Incorrect Fire Suppression Cranes and Lifting Working At Heights Confined Space Mobile Equipment Compliance to mine procedures

  • FLRA not used/right for task
  • JSA not used/right for task
  • SOP not used/right for task
  • Procedure not known
  • Procedure not understood
  • Procedure not followed
  • Isolation Incorrect
  • Fire Suppression
  • Cranes and Lifting
  • Working At Heights
  • Confined Space
  • Mobile Equipment
  • Compliance to mine procedures

• Housekeeping:

  Select Trip hazards Slip hazards Protrusions Rubbish No Waste Management No Signage Poor Storage No Demarcation Poor Ventilation Poor Ground Conditions Dust Control Roads Good Housekeeping practices observed

  • Trip hazards
  • Slip hazards
  • Protrusions
  • Rubbish
  • No Waste Management
  • No Signage
  • Poor Storage
  • No Demarcation
  • Poor Ventilation
  • Poor Ground Conditions
  • Dust Control
  • Roads
  • Good Housekeeping practices observed

• Improvements Discussed:

• Team Leader:

  Sign