Planned Task Observation -KAXU Project

• KAXU Safety Compliance

• Document No.

• Work area assessed

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel involved: (Observer, Site supervisor, employees and Safety officer/s included)

• Occupation of the person being assessed:

• Contractor supervisor involved

Safety statistics

• Amount of PTO's conducted this week? (Verify)

  Compliant

  Non-compliant

• Amount of toolbox talks completed this week. (Verify)

  Compliant

  Non-compliant

• Employee daily strength?

  Yes

  No

  N/A

• Weekly registers submitted? (Verify)

  Compliant

  Non-compliant

Compliance Observations (Task based)

• Is there a risk assessment for the task being observed?

  Yes

  No

  N/A

• Is the task being conducted covered by a Procedure or method statement?

  Yes

  No

  N/A

• Has the person being observed signed the PTO?

  Yes

  No

  N/A

• Is the PTO for the task completed correctly?

  Yes

  No

  N/A

• Are all site management rules being complied with during the task? (PPE requirements, traffic management, etc)

  Yes

  No

  N/A

• Does the person being observed have the appropriate competencies required for the task?

  Yes

  No

  N/A

• Is a work permit required for the task? <br><br>If so, is the permit approved by the KAXU safety department and Team leader/s?

  Yes

  No

  N/A

• Is all appropriate PPE used as prescribed?<br><br>PPE correctly applied?

  Yes

  No

  N/A

• Is all plant and equipment being used for the task fit for purpose and in a safe and serviceable condition?

  Yes

  No

  N/A

• Is the working environment safe to complete the task? (bund walls in place, weather conditions, etc)

  Yes

  No

  N/A

• Is adequate communication being used between workers completing the task? (two way radios, visual, etc?)

  Yes

  No

  N/A

• Is there any source of energy present, identified and attended to? (Eliminate or Isolate)

  Yes

  No

  N/A

• Is there any training required for the task and is the worker competent to perform the task?

  Yes

  No

  N/A

• Is the four steps to safety applied and was the person observed able to relate to it with regards to the task that is carried out?

  Yes

  No

  N/A

• Is simultaneous operations taking place and have all parties communicated with each other? (Joint operations)

  Yes

  No

  N/A

Instructions or advice provided? GUTS principle applied? (Greet, understand, talk and support) principle applied?

• Instructions to make the task safer

• Advice given

• Positive Feedback to Observed Person

• Opportunities for Improvement

CSP deviations - KAXU CSP

• Vehicle and mobile equipment

  Safe

  At Risk

  N/A

• Ground control

  Safe

  At Risk

  N/A

• Hazardous material

  Safe

  At Risk

  N/A

• Isolation and lock-out

  Safe

  At Risk

  N/A

• Permit to work

  Safe

  At Risk

  N/A

• Working at height

  Safe

  At Risk

  N/A

• Lifting operations

  Safe

  At Risk

  N/A

• Drowning

  Safe

  At Risk

  N/A

• Equipment safe guarding

  Safe

  At Risk

  N/A

• Oxy-fuel gas

  Safe

  At Risk

  N/A

• Others not CSP

  Safe

  At Risk

  N/A

Behaviour deviations

• Checklists completed correctly?

  Yes

  No

  N/A

• Pre-use inspection carried out

  Yes

  No

  N/A

• SOP followed

  Yes

  No

  N/A

• Hazards identified

  Yes

  No

  N/A

• Negligence or in violation

  Safe

  At Risk

  N/A

• Authorised to perform task

  Yes

  No

  N/A

• Licences for the task

  Yes

  No

  N/A

• OEM specifications followed

  Yes

  No

  N/A

• PPE compliant - correct use

  Yes

  No

  N/A

• Safety devices tampered with?

  Yes

  No

  N/A

• Intoxication - drugs and or alcohol

  Yes

  No

  N/A

System deviations

• Checklist completed

  Yes

  No

  N/A

• Risk assessment completed and signed by all employees. (Please verify through documented proof)

  Yes

  No

  N/A

• MSDS available (Records of all MSDS's and proof of communication through tool box talks)

  Yes

  No

  N/A

• Safe operating procedures in place? (Acknowledged by all employees through tool box talks)

  Yes

  No

  N/A

• Proof of competency

  Yes

  No

  N/A

• Proof of training

  Yes

  No

  N/A

• Operating outside scope of work

  Safe

  At Risk

  N/A

• Operational requirements specified

  Yes

  No

  N/A

• PPE availability

  Yes

  No

  N/A

Equipment deviations

• Safe access and egress

  Safe

  At Risk

  N/A

• Chemicals controlled effectively

  Safe

  At Risk

  N/A

• Design requirements followed

  Yes

  No

  N/A

• Use of correct tools for the task

  Yes

  No

  N/A

• Electrical equipment safety

  Safe

  At Risk

  N/A

• Engineering changes documented

  Yes

  No

  N/A

• Engineering approval

  Yes

  No

  N/A

• Ergonomics addressed

  Yes

  No

  N/A

• Housekeeping

  Safe

  At Risk

  N/A

• Maintenance

  Safe

  At Risk

  N/A

• Lockout facilities

  Yes

  No

  N/A

• Safe guarding (Machinery)

  Safe

  At Risk

  N/A

• Operating within limits

  Safe

  At Risk

  N/A

• Spillages observed

  Safe

  At Risk

  N/A

• Unsafe acts

  Safe

  At Risk

  N/A

• Unsafe conditions

  Safe

  At Risk

  N/A

Signatures

• Signature of the Observer

  Sign

• Signature of the person being observed

  Sign

• Signature of the Supervisor / Foreman

  Sign