LLS - Safe Act Observation

• Document No.

• Audit Title

• Work Order Number

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Planning (does the person....)

• Ensure the people are competent to do the task

  Safe

  At Risk

  N/A

• Inspect the area, tools and equipment before use

  Safe

  At Risk

  N/A

• Identify and communicate any hazards or risks to fellow workers

  Safe

  At Risk

  N/A

• Look at SWP or work instruction where available

  Safe

  At Risk

  N/A

• Undertake a pre-start check

  Safe

  At Risk

  N/A

• Identify permit requirement

  Safe

  At Risk

  N/A

• Complete a Take-5/SWMS for the task

  Safe

  At Risk

  N/A

• MSDS Available and has awareness of substances to be used

  Safe

  At Risk

  N/A

• Identify the correct tools and equipment to carry out the task at hand

  Safe

  At Risk

  N/A

Body Posture (does the person....)

• Position their body such that they avoid being struck, sprayed, crushed, pinned or in contact with a release of stored energy

  Safe

  At Risk

  N/A

• Take care in looking where they are moving, walking or driving

  Safe

  At Risk

  N/A

• Concentrate on the job at hand

  Safe

  At Risk

  N/A

• Consider the general secure layout of the work area

  Safe

  At Risk

  N/A

Manual Handling (does the person....)

• Lift correctly using their legs

  Safe

  At Risk

  N/A

• Maintain balance, no over stretching or twisting whilst handling equipment

  Safe

  At Risk

  N/A

Driving and operating (does the person....)

• Wear seat belts provided

  Safe

  At Risk

  N/A

• Drive to the conditions of the roadways

  Safe

  At Risk

  N/A

• Use the horn, indicators and lights as required

  Safe

  At Risk

  N/A

• Use flagpole/whip aerial

  Safe

  At Risk

  N/A

• Check to ensure emergency stop switches are working

  Safe

  At Risk

  N/A

Personal protecting clothing and equipment (is the equipment....)

• In a good, clean state of repair

  Safe

  At Risk

  N/A

• Worn as required and in line with identified inherent hazards

  Safe

  At Risk

  N/A

• The correct type for the job at hand

  Safe

  At Risk

  N/A

Isolation and tagging (has the person....)

• Applied positive isolation where required

  Safe

  At Risk

  N/A

• Applied a danger/out of service tag as required

  Safe

  At Risk

  N/A

• Used barrier tape or physical barriers where required

  Safe

  At Risk

  N/A

• Additional behaviours to be observed:

• Positive Feedback given to acceptable behaviours:

• Feedback and action items raised to eliminate At-Risk Behaviours:

• These items should be raised in the next toolbox meeting:

• Signature of Observer:

  Sign

• If serious At-Risk Behaviour (eg breach of procedure) has been observed, refer matter to the Area/Depot Manager