Title Page
-
Location of Gemba Walk
-
Prepared by
Operational Items
-
Machines in the area are equipped with standard machine guarding where necessary and secured in place to prevent unsafe access to the Point of Operation?
-
Have you instructed the operator stop the equipment and Lock Out until guards are reinstalled?
-
Any body part of the employee(s) observed inside of equipment not locked out?
-
The housekeeping of the area is maintained? (hoses rolled up, no debris on ground, spills/leaks are cleaned up, broken glass is swept up, ect.)
-
Housekeeping Issue Before
-
Housekeeping Issue Resolved
-
Employees are properly wearing company issued PPE?
-
Instruct employee on the Plant PPE Requirements and issue discipline.
-
SIF Focus (Select Month)
-
-
SIF Issue(s) found?
-
Describe Issue:
-
Describe what was immediately done to correct the behavior or condition
-
Describe positive feedback observed during your walk as it relates to SIF or any observation
-
-
SIF Issue(s) found?
-
Describe Issue:
-
Describe what was immediately done to correct the behavior or condition
-
Describe positive feedback observed during your walk as it relates to SIF or any observation
-
-
SIF Issue(s) found?
-
Describe Issue:
-
Describe what was immediately done to correct the behavior or condition
-
Describe positive feedback observed during your walk as it relates to SIF or any observation
-
Any additional concerns or issues brought up by employees on the floor?
-
Describe Issue
-
Immediate fix:
