Title Page

  • Prepared by / Disediakan oleh

Report Details / Perincian Laporan

  • Report by / Dilaporkan oleh

  • Project / Projek

  • Scope of Work / Skop Kerja

  • Department / Jabatan

  • Company / Syarikat

  • Date / Tarikh

Observation Details / Perincian Pemerhatian

  • Unsafe condition / Keadaan yang tidak selamat

  • Unsafe behavior / Perlakuan yang tidak selamat

  • Best practice / Tindakan yang baik

  • HSE suggestion / Cadangan HSE

  • Issue or concern / Isu atau komen

  • Security / Keselamatan

  • Lesson learned / Perkara yang dipelajari

  • Description of OBSERVATION / Penerangan Pemerhatian

Intervention Details / Perincian Teguran

  • Corrective Action / Tindakan pembetulan

  • Positive Intervention / Campuran tangan secara positif

  • Further action / Tindakan lanjut

  • Description of INTERVENTION / Penerangan Teguran

Root Cause Analysis / Analisa Punca Kejadian

Personnel Factor / Faktor Kendiri

  • Lack of skills or knowledge / Kekurangan kemahiran atau pengetahuan

  • Using the correct way takes more time and or effort / Menggunakan cara yang betul memerlukan lebih banyak masa dan usaha

  • Not following the correct practice is positively reinforced or tolerated / Tidak mengikuti amalan yang betul boleh ditoleransi

  • Deviations from the correct practice have not resulted in problems in the past / Tidak mengikuti cara yang betul tidak menghasilkan masalah pada masa lalu

Job Factor / Faktor Kerja

  • Lack or inadequate procedures or standards / Prosedur atau standard yang kurang atau tidak mencukupi

  • Inadequate communication of expectations, procedures or standards / Komunikasi berkenaan prosedur atau standard yang tidak mencukupi

  • Substandard of tools or equipment. (Availability, Design, Condition) / Kekurangan dari segi alat atau peralatan. (Ketersediaan, Reka Bentuk, Keadaan)

External Factor / Faktor Luaran

  • Weather / Cuaca

  • Surrounding / Kawasan sekeliling

Intervention Evidence / Bukti Pembetulan

  • Photo of Observation / Bukti Pemerhatian

  • Photo of Intervention / Bukti Tindakan

HSE Sharing / Perkongsian HSE

  • Toolbox Meeting / Mesyuarat toolbox

  • On-Job Training / Latihan dalam kerja

  • Short Briefing / Taklimat ringkas

  • HSE Program / Program HSE

  • HSE Alert Dissemination / Sebaran Makluman HSE

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. You should independently determine whether the template is suitable for your circumstances.