SAFETY ACT OBSERVATION

Safe Act Observation

• Candidate Name

• Observer’s Name

• Site & Location

• Task/ Activity Observed

• SWMS/JSEA Name:

• Date

  Date

Documentation

• SWMS/JSEA

  Yes

  No

  N/A

• Personal Risk Assessment

  Yes

  No

  N/A

• Other (specify)

Pre-Start Operations

• Has a JHA and or task specific risk assessment been completed (Take 5, etc.)?

  Yes

  No

  N/A

• Has the crew on the job conducted a pre-start inspection prior to commencing the job?

  Yes

  No

  N/A

• Has a pre-start inspection been conducted on tools and equipment to be used for the task/activity?

  Yes

  No

  N/A

• Have all relevant procedures been reviewed and understood prior to the task/activity?

  Yes

  No

  N/A

• Is the operator authorised to operate plant/equipment being utilised for the task/activity?

  Yes

  No

  N/A

• Have all Restricted Work Areas (RWA) and exclusion zones been erected, including signage?

  Yes

  No

  N/A

• Other

Position Of People

• At risk of flying objects – are you in the line of fire?

  Yes

  No

  N/A

• At risk from pinch/crush points – hands/fingers/body in a position where<br>they shouldn’t be?

  Yes

  No

  N/A

• At risk of sprains/strains from over extension, lifting heavy objects etc. –<br>incorrect body position?

  Yes

  No

  N/A

• At risk of slips/trips/falls or falling objects – in and around the work area?

  Yes

  No

  N/A

• At risk of sprains/strains from over extension, lifting heavy objects etc. –

  Yes

  No

  N/A

• At risk from any type of pressure – air/water/heat/hydraulic/fume/gasses?

  Yes

  No

  N/A

• At risk from overhead obstructions – power lines, lightning strikes, under<br>body debris?

  Yes

  No

  N/A

Personal Protective Equipment

• Safety Helmet present while performing task?

  Yes

  No

  N/A

• Correct footwear worn while performing task?

  Yes

  No

  N/A

• Gloves present while performing task?

  Yes

  No

  N/A

• Wearing suitable protective clothing (long sleeves rolled down & buttoned, shirt tucked in, etc)?

  Yes

  No

  N/A

• Correct safety glasses worn?

  Yes

  No

  N/A

• Hearing protection present while performing task relevant to site requirements

  Yes

  No

  N/A

• Other

Tools and Equipment

• Correct tools used for the task/activity?

  Yes

  No

  N/A

• Tools in safe condition?

  Yes

  No

  N/A

• Tools used correctly to perform job task?

  Yes

  No

  N/A

• Positive communication used whilst operating machinery/equipment/tooling?

  Yes

  No

  N/A

• Spotter present when operating machinery/equipment/plant in and out of work area?

  Yes

  No

  N/A

• Have all isolation (energy sources) been controlled & tested for this task?

  Yes

  No

  N/A

• Other

Housekeeping

• Tools and equipment cleaned and stored correctly?

  Yes

  No

  N/A

• All ground debris cleaned up?

  Yes

  No

  N/A

• Barricading and signage removed from the work area on completing job?

  Yes

  No

  N/A

• Hoses/Airlines/Electrical Cords rolled away and back on reels where applicable?

  Yes

  No

  N/A

• Walkways & entry areas clear and free from obstructions?

  Yes

  No

  N/A

• Trolleys/lifting devices used to assist with moving/lifting objects?

  Yes

  No

  N/A

• Other

Comments

• (Safe) Act/s Observed within the task. What were the safe act/acts observed?

• (Unsafe) Act/s Observed within the task. What were the unsafe act/acts observed?

• Discussion Points/Agreed Actions

Completion

• Observers Name

• Observers Signature

  Sign

• Candidate Name

• Candidate Signature

  Sign

• Date

  Date

• OTHER