Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Safe work observation form

  • Location
  • Select date

  • Description of works to be undertaken :

  • Number of people observed

  • Any activity that has the potential to cause serious injury shall be stopped and appropriate corrective action implemented immediately.

Observed at risk category PPE

  • Head

  • Eyes/face

  • Eyes/face

  • Hearing

  • Respiratory

  • Hand

  • Body

  • Feet

  • Add media

Observed at risk category Procedure

  • JSA / SOP

  • Test n tag in date

  • Pre start checks

  • Job preparation and task instructions

  • Chemical use and understanding

Observed at risk category working environment

  • Housekeeping

  • Barricading

  • Thermal comfort

  • Storage

  • Facility conditions

  • Working conditions

  • Others

  • Others

Observed at risk category tools/equipment

  • Selection

  • Condition

  • Use

  • Current test tag

  • Compliance / lifting,slings,chains,

Observed at risk category body use/ postion

  • Line of Fire

  • Lifting

  • Pushing/pulling

  • Carrying

  • Climbing three point of contact

  • Posture

  • Other

Mobile equipment

  • In good condition

  • Being used correctly, Use

  • Enter /Exit

  • Pedestrian segregation

  • Being used correctly, Use

  • Enter /Exit

Area of concern / Commendable Safe Behaviours Observed

  • Are there any parts of the job that are "Critical"and need to be altered?

  • Identify type of follow up actions required , persons responsible and date for the implementation.

  • Select date

  • Officers name

  • Submit completed form to Safety Officer
    All at risk categories identified will be placed in the OSH progress report for auctioning

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.