Information
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Department
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Date:
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Task/ Job Description:
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Machine/ Equipment number:
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Document No.
Reason for Observation
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New Worker
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Routine Observation
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Worker with known ability problem
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Risk Taker
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Worker received on the job training
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Unsafe Conditions
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Incident - Injury
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Incident - Damage
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Verify SOP is correct
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High Risk task
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Identifying Training Needs
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Change In process
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Refresher training
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On- the - Job training received
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Other
Observations
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Did the person being observed attend the daily pre start meeting?
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Is the task being conducted covered by a procedure?
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Has the person being observed trained on the procedure?
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Required PPE used?
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Was a Risk Assessment done? (SLAM - STOP, LOOK, ASSESS, MANAGE)
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Was the risk assessment communicated?
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Does the person being observed have the appropriate competencies required for the task?
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Where machinery and equipment are used or operated, does the operator or user have a clear and good understanding of the Safe Operating Proccedures/ Safe Work Instructions?
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Does the operator or user understand the risk and hazards involved in the use or operation of the machine?
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Does the user or operator understand what to do during an emergency?
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Has a Pre Start Check been completed for the items of plant being used?
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Is equipment or machinery being used for the task fit for purpose and in a safe and serviceable condition?
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Are all E- Stops tested for functionality during the prestart check?
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Is the working environment safe to complete the task?
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Is adequate communication being used between workers completing the task?
Additional Hazards Identified?
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Instructions or Advice Provided to Person Being Observed?
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Instructions Provided
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Advice Provided
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Positive Feedback to Observed Person
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Opportunities for Improvement/ Recommendations
Notes
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undefined
Signatures
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Person Conducting Observation
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Person being Observed