Positive Observations At Risk Actions / Conditions At Risk Items Rectified Opportunities for Improvement CHECKLIST - Tick if Any AT RISK
People
Select
Line of Fire (eg. struck by/against
Pinch Points (eg. caught in/on/between
Position/Posture (eg. awkward, static)
Movements (eg. repetitive)
Falling (eg. fall from height, trip)
Manual Handling (eg. push/pull, lift/lower)
Hazardous Substance (eg. contact, inhalation)
Temperature Extremes
Contact with Electricty
NIL
Line of Fire (eg. struck by/against Pinch Points (eg. caught in/on/between Position/Posture (eg. awkward, static) Movements (eg. repetitive) Falling (eg. fall from height, trip) Manual Handling (eg. push/pull, lift/lower) Hazardous Substance (eg. contact, inhalation) Temperature Extremes Contact with Electricty NIL
Job Set-Up
Select
Housekeeping
Barricades (eg. exclusion/drop zones)
PPE (eg. selection, condition, use)
Dropped Objects (eg. lanyards)
NIL
Housekeeping Barricades (eg. exclusion/drop zones) PPE (eg. selection, condition, use) Dropped Objects (eg. lanyards) NIL
Job Planning
Select
JHA (eg. complete, adequate, followed)
Take 5 (eg. complete, adequate, followed)
Permits/Isolations (eg. complete, tested)
Competency Verified (eg. PAR/VOC)
NIL
JHA (eg. complete, adequate, followed) Take 5 (eg. complete, adequate, followed) Permits/Isolations (eg. complete, tested) Competency Verified (eg. PAR/VOC) NIL
Tools / Equipment
Select
Selection (eg. right for the job)
Condition (eg. safe, tested/tagged)
Use (eg. used correctly)
NIL
Selection (eg. right for the job) Condition (eg. safe, tested/tagged) Use (eg. used correctly) NIL
Add media
Media
link copied
Jason Lamont
MONADELPHOUS - INTERACTION
Based on Safety Interaction MGL-F-1004
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.