Observation of a PIC/COSS - SQP1 - Non IP/Maintenance-Silver to Platinum

• Site conducted

  Select

• Name of PIC/COSS

• Sentinel Number

• Company/Sponsor

  Deploy

  Colemans

  RTIS

  RSL

  Other

• Please specify

• Site

• PIC/COSS contact Number

• Observer

  Matt Hewett

  Andy Childs

  Steve Paul

  Daren Norris

  Other

• Please Specify

• Conducted on

  Date

• Type of Duty

  PIC

  Safe Work Leader

  Task Leader

  other

• Please Specify

• Nature of Work / Protection Type

• COSS Classification

  Select Unknown Known Bronze Silver Gold Platinum

  • Unknown
  • Known
  • Bronze
  • Silver
  • Gold
  • Platinum

• Potential for Progression

  Select Unknown Known Bronze Silver Gold Platinum

  • Unknown
  • Known
  • Bronze
  • Silver
  • Gold
  • Platinum

Group 1: Paperwork, Sentinel Check & Planning

• Challenging Conversation?

  Yes

  No

• Please give more details

• Did the COSS check the 3rd rail location before starting work? pay particular attention to 3rd Rail being in the CESS side in Platform areas and in areas of darkness

  Yes

  No

  N/A

• if not, why not brief on recent OCC

  Yes

  No

• Sentinel Card Check of work group

  Yes

  No

• Please give more details

• Sentinel Swipe of work group

  Yes

  No

• Please give more details

• Track Permits (OLP/CRP)

  Yes

  No

  N/A

• Please give more details

• SWP Check by PDM

  Yes

  No

• Please give more details

• Planning (Does the PIC/COSS understand the plan they will be implementing)

  Yes

  No

• Please give more details

• Does the COSS/PIC have access to the Rule Book

  Yes

  No

• Please give more details

• Was their Time Keeping acceptable? Was the individual on site 90 mins pre start time

  Yes

  No

• Why Not

• Compliance Paperwork (COSS briefing checklist, CP checklist, Marker board erection, PIC H&S checklist, PC Checklist

  Yes

  No

• Please give more details

Group 2: Set up SSOW

• Was the NR3180 completed properly and fully?

  Yes

  No

  N/A

• Please give more details

• Authority Number (Red zone authority/change of SSOW etc)

  Yes

  No

  N/A

• what was the Authority number(S) for?

• Did the COSS/PIC use the COSS briefing checklist for their brief to the staff?

  Yes

  No

• Please give more details

• Was the SSOW Implemented Correctly ?

  Yes

  No

• Please give more details

• Was the Protection Set Out Correctly?

  Yes

  No

  N/A

• Please give more details

Group 3: Minimum Standards Requirements

• Was their PPE adequate, clean and tidy and correct sponsor shown?

  Yes

  No

• Please give more details

• Was their equipment in good condition and with applicable certification/Calibration?

  Yes

  No

• Please give more details

• Does the COSS/PIC have sufficient Rulebook Knowledge (ask questions to ascertain)

  Yes

  No

• Please give more details

• Does the individual have the ability to communicate in English (both written and oral)

  Yes

  No

• Feedback to the rail assurance team and stay with them until the shift is completed

  Yes

  No

Group 4: Site Specific Requirements

• Site Limits Defined correctly?

  Yes

  No

• Please give more details

• Access and Egress Limits Defined

  Yes

  No

• Please give more details

• Welfare

  Adequate

  Inadequate

  N/A

• Please give more details

• Did the COSS/PIC identify any Additional Hazards?

  Yes

  No

  N/A

• Please give more details

• Did the COSS/PIC understand and Brief the Emergency Procedures

  Yes

  No

• Please give more details

• Nearest Hospital

  Yes

  No

• Please give more details

• did the COSS/PIC brief any Life Saving Rules?

  Yes

  No

• Please give more details

• Is there sufficient task Lighting? (Pay particular attention to track level works especially within platform areas?

  Yes

  No

  N/A

• Consider stopping works until resolved

  Yes

  No

• Site Conditions (eg wet, dry, flog...etc)

Situational Awareness: • Attention to detail • Overall awareness • Maintain concentration • Retain information (during shift) • Anticipation of risk

• Situational Awareness Score:<br>1 - Support & Mentoring Required<br>2 - Working to Satisfactory Levels<br>3 - Exceeding Required Levels

  3

  2

  1

Conscientiousness: • Systematic and thorough approach • Checking • Positive attitude towards rules and procedures – ask team why they believe we are having operational close calls. • Understands purpose of role and takes responsibilities seriously

• Conscientiousness Score:<br>1 - Support & Mentoring Required<br>2 - Working to Satisfactory Levels<br>3 - Exceeding Required Levels

  3

  2

  1

Communication: • Listening (people not stimuli) • Clarity - Was the COSS briefing understandable and clear on the Safe System of Work (SSOW)? • Did the COSS use open questioning to check the group’s understanding of his/her briefing? • Did the COSS provide opportunity/ time for workgroup challenge? • Did the ES clearly understand the extent of the isolation, worksite limits and marker board positions? • Assertiveness • Did the COSS provide constructive feedback to the workgroup? • Did the COSS welcome constructive feedback on his/her performance? • Sharing information (How many Close Calls – have discussion)

• Communication Score:<br>1 - Support & Mentoring Required<br>2 - Working to Satisfactory Levels<br>3 - Exceeding Required Levels

  3

  2

  1

Workload management: • Multi-tasking and selective attention • Prioritising • Calm under pressure • How many staff signed in with PC or COSS or ES?

• Workload Management Score:<br>1 - Support & Mentoring Required<br>2 - Working to Satisfactory Levels<br>3 - Exceeding Required Levels

  3

  2

  1

Self-management: • Time management • Alert and energised (not suffering from fatigue/tiredness) • Motivation • Confidence and initiative • Maintain and develop skills and knowledge • Prepared and organised

• Self-Management Score:<br>1 - Support & Mentoring Required<br>2 - Working to Satisfactory Levels<br>3 - Exceeding Required Levels

  3

  2

  1

Behavioural, Cultural & Additional Skills

• Safety Responsibility Statement signed?

  Yes

  No

• Attendance at Safety Critical Induction?

  Yes

  No

• Attendance at Stop Think session?

  Yes

  No

• Attendance to Octavius Safety Critical Communication Training?

  Yes

  No

• SMSTS Held?

  Yes

  No

  N/A

• SSSTS Held?

  Yes

  No

  N/A

• First Aid?

  EFA

  Full First Aid At Work (3 day)

  None

Have you been formally briefed and do you understand the requirements when working with Octavius. Questions to ask to confirm this…

• Have you been formally briefed and do you understand the requirements when working with Octavius. Questions to ask to confirm this…

  Yes

  No

• go through the induction again

  Yes

  No

Have you been fully briefed on Octavius processes, including all additional paperwork, morning reports and support?

• Who is Octavius RIPS Manager?

  Correct Answer Given

  Wrong Answer Given

• Who may authorise Open Line Working?

  Correct Answer Given

  Wrong Answer Given

• when implementing a Line Blockage with Detonator protection, what form needs to be completed?

  Correct Answer Given

  Wrong Answer Given

• At the end of each shift, what form needs to be completed?

  Correct Answer Given

  Wrong Answer Given

• Before you leave site where do you need to send all completed paperwork and pictures?

  Correct Answer Given

  Wrong Answer Given

Have you been formally briefed and do you understand the requirements of the controls required on Octavius sites when Working in multiple COSS Line Blockages with PC? Questions to ask to confirm this…

• Explain the signing in arrangements for COSS with PC, and how authority to access the track is authorised once the line is blocked?

  Correct Answer Given

  Wrong Answer Given

• Re Brief

  Yes

  No

• How many COSSs may a PC sign in on to the line blockage?

  Correct Answer Given

  Wrong Answer Given

• Re Brief

  Yes

  No

• When acting as a PC what form needs to be completed?

  Correct Answer Given

  Wrong Answer Given

• Re Brief

  Yes

  No

Have you been formally briefed and do you understand the requirements of the ‘Till Dawn Lamps Process? Questions to ask to confirm this…

• Explain the purpose of the ‘till dawn process and who is responsible for implementing it.

  Correct Answer Given

  Wrong Answer Given

• Please detail your overall recommendations and any commendations/Improvement Opportunities:

• COSS/PIC Signature

  Sign

• PDM Signature

  Sign

• A COPY OF THIS COMPLETED FORM MUST BE SENT TO THE PRINCIPAL CONTRACTOR’S RIPS MANAGER AND SOUTHERN SHIELD SLT REPRESENTATIVE.