Safe Behaviour Observation (SBO) 04-26-01 issue date: 27/07/2017

• Safe Behaviour Observation (SBO)

• Document No.

• Engineering department

• Conducted on

  Date

• Observer

• Location
  Address

• Personnel

PPE

• Is the person/s wearing the correct PPE for the task they currently undertaking?

  Yes

  No

  N/A

• Is PPE supplied adequate for the task?

  Yes

  No

  N/A

• Is PPE being worn properly?

  Yes

  No

  N/A

Emergency procedures.

• Can the worker produce a RADAR booklet and/or a JSA form for their work task?

  Yes

  No

  N/A

• Can the worker describe where the closest fire alarm is?

  Yes

  No

  N/A

• Can the worker describe where the closest evacuation assembly area is?

  Yes

  No

  N/A

• Can the worker describe where the closest fire hose and fire extinguisher is located?

  Yes

  No

  N/A

Worker/s to identify 3 key hazards.

• Hazard no. 1

  Yes

  No

  N/A

• Hazard no. 2

  Yes

  No

  N/A

• Hazard no. 3

  Yes

  No

  N/A

Observer/s to make 3 observations and obtain a response

• Observation no. 1

  Yes

  No

  N/A

• Observation no. 2

  Yes

  No

  N/A

• Observation no. 3

  Yes

  No

  N/A

Signature and Finalization

• General Comments/Feedback

• I have completed this assessment to the best of my knowledge. This audit is not intended to identify all safety and health hazards, but to identify all visible/known hazards as of the date printed on the completed assessment.

  Sign

• Workers signature

  Sign

• Supervisors signature

  Sign

• Select date

  Date

• Overall Safety Score