Planned Task Observation

• Department

• Date:

  Date

• Task/ Job Description:

• Machine/ Equipment number:

• Document No.

Reason for Observation

• New Worker

• Routine Observation

• Worker with known ability problem

• Risk Taker

• Worker received on the job training

• Unsafe Conditions

• Incident - Injury

• Incident - Damage

• Verify SOP is correct

• High Risk task

• Identifying Training Needs

• Change In process

• Refresher training

• On- the - Job training received

• Other

Observations

• Did the person being observed attend the daily pre start meeting?

  Yes

  No

  N/A

• Is the task being conducted covered by a procedure?

  Yes

  No

  N/A

• Has the person being observed trained on the procedure?

  Yes

  No

  N/A

• Required PPE used?

  Yes

  No

  N/A

• Was a Risk Assessment done? (SLAM - STOP, LOOK, ASSESS, MANAGE)

  Yes

  No

  N/A

• Was the risk assessment communicated?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 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?

  Yes

  No

  N/A

• Does the operator or user understand the risk and hazards involved in the use or operation of the machine?

  Yes

  No

  N/A

• Does the user or operator understand what to do during an emergency?

  Yes

  No

  N/A

• Has a Pre Start Check been completed for the items of plant being used?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are all E- Stops tested for functionality during the prestart check?

  Yes

  No

  N/A

• Is the working environment safe to complete the task?

  Yes

  No

  N/A

• Is adequate communication being used between workers completing the task?

  Yes

  No

  N/A

Additional Hazards Identified?

• undefined

Instructions or Advice Provided to Person Being Observed?

• Instructions Provided

• Advice Provided

• Positive Feedback to Observed Person

• Opportunities for Improvement/ Recommendations

Notes

• undefined

Signatures

• Person Conducting Observation

  Sign

• Person being Observed

  Sign