Title Page

  • Safety Buddy:

  • Observer:

  • Conducted on

  • Line/Equipment ID
  • What did you observe?

  • Where did it happen?

  • Mark each of the following behaviors as SAFE or AT RISK

Top 3 Behaviors to observe for Bakery

  • Colleague has met with Safety Buddy and understands how to do a BOS?

  • Colleague knows where emergency equipment is located. (Eyewash, fire extinguisher, exits for example)

  • Colleague knows last safety talk or topic?


  • Colleague uses the right tool(s) for the job to avoid repetition or overexertion

  • Colleague uses appropriate techniques when lifting or carrying


  • Colleague stores and uses PPE as indicated in the area/activity and in its original condition


  • Colleague keeps his/her workstation in order

  • Colleague keeps area clear of slip, trip or fall hazards

  • Colleague uses the pedestrian walkways in the facility

  • Colleague holds the handrails or keeps 3 points of contact ascending/descending (stairs, stepladders, etc)

  • Colleague is aware of and safely uses chemical substances in this work area


  • Colleague knows the hazards and risks of the workplace and properly uses a Safety Map

  • Colleague properly engages QRP or permit to work tools when appropriate


  • Colleague operates equipment correctly without presenting new hazards (observes speed limits, seat belts, horns, etc)


  • Colleague adequately applies LOTO and carries personal locks

  • Colleague operates machines with guards in placey


  • Anything thing else observed or discussed?

Step 2. Provide Feedback, encourage action and thank your colleague

  • Describe the feedback you shared. Was it well received?

  • Any actions recommended or taken (defect card, Kaizen, Recognition card)?

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.