NWB Safety GEMBA

• Conducted on

  Date

• Person coached and mentored

  Select 1. PPE – Not worn appropriately (Hairnet not over the ears), not neat, clean, damaged 2. Not washing and sanitising hands when entering the plants 3. Not using gloves when directly handling food or as required for the task 4. Eating food directly from the food stream 5. Eeating/drinking at the line 6. Taking medication at the line 7. Leaving used equipment/cleaning tools/PPE lying around 8. Using unlabelled chemicals, ingredients or WIP containers 9. Other No issue found

  • 1. PPE – Not worn appropriately (Hairnet not over the ears), not neat, clean, damaged
  • 2. Not washing and sanitising hands when entering the plants
  • 3. Not using gloves when directly handling food or as required for the task
  • 4. Eating food directly from the food stream
  • 5. Eeating/drinking at the line
  • 6. Taking medication at the line
  • 7. Leaving used equipment/cleaning tools/PPE lying around
  • 8. Using unlabelled chemicals, ingredients or WIP containers
  • 9. Other
  • No issue found

• Prepared by

• Site

  Select

1. Safety

• A. Worksite Hazards

  Select 1. Unguarded points of operation with moving parts 2. Damaged guards 3. Missing guards 4. Guards removed for cleaning but not reinstalled 5. Nuts and bolts missing from the guarding rendering it loose 6. Other No issue found

  • 1. Unguarded points of operation with moving parts
  • 2. Damaged guards
  • 3. Missing guards
  • 4. Guards removed for cleaning but not reinstalled
  • 5. Nuts and bolts missing from the guarding rendering it loose
  • 6. Other
  • No issue found

• Specify

• B. Forklift Safety

  Select 1. Driving too fast or above maximum speed limit of 8km 2. Seatbelt not fastened 3. Driving with no license or expired license 4. Double stacking/ unstable or poor load stacking 5. Not sounding the horn when approaching pedestrians 6. Faded pedestrian walkways 7. Pedestrians entering prohibited forklift zones only 8. Pedestrians not using the designated walkways 9. No segregated walkway/barriers for pedestrians in forklift areas 10. Talking on mobile phone whilst driving or walking in a forklift-controlled area 11. Unsafe driving – damaging building & equipment 12. Other 13. No issue found

  • 1. Driving too fast or above maximum speed limit of 8km
  • 2. Seatbelt not fastened
  • 3. Driving with no license or expired license
  • 4. Double stacking/ unstable or poor load stacking
  • 5. Not sounding the horn when approaching pedestrians
  • 6. Faded pedestrian walkways
  • 7. Pedestrians entering prohibited forklift zones only
  • 8. Pedestrians not using the designated walkways
  • 9. No segregated walkway/barriers for pedestrians in forklift areas
  • 10. Talking on mobile phone whilst driving or walking in a forklift-controlled area
  • 11. Unsafe driving – damaging building & equipment
  • 12. Other
  • 13. No issue found

• Specify

• C. Energy Isolation (LOTO)

  Select 1. Unguarded points of operation with moving parts 2. Damaged guards 3. Missing guards 4. Guards removed for cleaning but not reinstalled 5. Nuts and bolts missing from the guarding rendering it loose 6. Other No issue found

  • 1. Unguarded points of operation with moving parts
  • 2. Damaged guards
  • 3. Missing guards
  • 4. Guards removed for cleaning but not reinstalled
  • 5. Nuts and bolts missing from the guarding rendering it loose
  • 6. Other
  • No issue found

• Specify

• D. Hand Safety

  Select 1. Unguarded points of operation with moving parts 2. Damaged guards 3. Missing guards 4. Guards removed for cleaning but not reinstalled 5. Nuts and bolts missing from the guarding rendering it loose 6. Other No issue found

  • 1. Unguarded points of operation with moving parts
  • 2. Damaged guards
  • 3. Missing guards
  • 4. Guards removed for cleaning but not reinstalled
  • 5. Nuts and bolts missing from the guarding rendering it loose
  • 6. Other
  • No issue found

• Specify

• E. Working at Heights

  Select 1. Unguarded points of operation with moving parts 2. Damaged guards 3. Missing guards 4. Guards removed for cleaning but not reinstalled 5. Nuts and bolts missing from the guarding rendering it loose 6. Other No issue found

  • 1. Unguarded points of operation with moving parts
  • 2. Damaged guards
  • 3. Missing guards
  • 4. Guards removed for cleaning but not reinstalled
  • 5. Nuts and bolts missing from the guarding rendering it loose
  • 6. Other
  • No issue found

• Specify

• F. Manual Handling

  Select 1. Damaged ladders/scaffolding 2. Not wearing harness or bump caps if it is a requirement 3. Leaving safety gates/doors open after use 4. Incorrect/dangerous use of equipment 5. No license or expired for use of elevated work platforms 6. Not competent/trained to perform the task 7. Other No issues found

  • 1. Damaged ladders/scaffolding
  • 2. Not wearing harness or bump caps if it is a requirement
  • 3. Leaving safety gates/doors open after use
  • 4. Incorrect/dangerous use of equipment
  • 5. No license or expired for use of elevated work platforms
  • 6. Not competent/trained to perform the task
  • 7. Other
  • No issues found

• Specify

• G. Machine Guarding

  Select 1. Damaged ladders/scaffolding 2. Not wearing harness or bump caps if it is a requirement 3. Leaving safety gates/doors open after use 4. Incorrect/dangerous use of equipment 5. No license or expired for use of elevated work platforms 6. Not competent/trained to perform the task 7. Other No issues found

  • 1. Damaged ladders/scaffolding
  • 2. Not wearing harness or bump caps if it is a requirement
  • 3. Leaving safety gates/doors open after use
  • 4. Incorrect/dangerous use of equipment
  • 5. No license or expired for use of elevated work platforms
  • 6. Not competent/trained to perform the task
  • 7. Other
  • No issues found

• Specify