Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Liaison Name:

  • Date and Time

  • Shift

  • Team Member Name:

  • Department:

  • Supervisor of Team Member

  • Objective: To engage in a personal, face-to-face, conversation with an operator or maintenance team member regarding safety. It should emphasize the behavior aspects of safety. Focus on SafeStart States (Rushing, Frustration, Fatigue, Complacency) and Critical Errors (Eyes Not on Task, Mind Not on Task, Line of Fire, Loss of Balance, Traction or Grip).

  • Scope: This "Touch Audit" is to be conducted once per shift on all new Team Members with less than 30 days on the shop floor.

  • Task being performed during the Touch Audit

  • States

  • Critical Errors

  • Desired Behaviors Exhibited During Audit:

  • Add media

  • Concerns Identified During Audit:

  • Add media

  • Agreed Upon Changes:

  • Add media

  • I agree to exhibit the desired behaviors and agreed upon changes as identified above:

  • Team Member Signature

  • Liaison Signature

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.