Safety Champion Progress Review

• Document No.

• Division

• Site / Job No

• Conducted on

  Date

• Prepared by

• Location
  Address

• Name and job role of Safety Champion

Safety Champion Leadership

• Good= The Safety Champion is recognised and identified within their workplace.<br>Very Good = The Safety Champion demonstrates a consistent level of excellence regarding H&S.<br>Excellent = The Safety Champion gets more members of the workforce involved in H&S.

  Good

  Very Good

  Excellent

• Innovation & Development Ideas?

• Response guidelines;
  Good:
  • Are they identified on their PPE (Hard Hat Stickers)?
  • Hi- Vi vest (OK to talk to me about safety)?
  • Identified in the site Induction?
  • Are other workforce aware of the safety champions in the workplace?
  Very Good:
  • Does the Safety Champion complete Safety observations (Both positive, areas for Improvement)?
  • Is the Safety Champion recognised as an ambassador for H&S?
  
  Excellent:
  • Do more operatives and sub-contractors complete safety observations?
  • Do they conduct a weekly tour?
  
  
  

Safety Champion Communication

• Good = All H&S communication is relevant to the works being undertaken.<br>Very Good = The Safety Champion demonstrates methods of delivering H&S messages.<br>Excellent =The Safety Champion demonstrates different ways of delivering H&S messages.<br>

  Good

  Very Good

  Excellent

• What could we focus on next?

• Response guidelines;
  Good:
  • Are Toolbox talks relevant and based on the risks associated with the works?
  • Does the Safety Champion have any input and suggestions regarding the toolbox talks?
  Very Good:
  • Does the Safety Champion avoid delivering TBT's to a script or list?
  • Does the safety Champion discuss the topic instead?
  Excellent:
  • Do they deliver briefings and TBT's in different ways?
  • Do they make the TBT's memorable, interesting?
  • Do they deliver the TBT's using visual aids, practical hands on delivery?
  • Does the Safety Champion communicate regularly with WCL safety department (Email, phone TXT etc)

Safety Champion Intervention

• Good = The Safety Champion consistently Intervenes and discusses H&S with operatives and sub-contractors.<br>Very Good = The Safety Champion demonstrates how to Intervene effectively.<br>Excellent = The Safety Champion empowers others to discuss H&S.

  Good

  Very Good

  Excellent

• Barriers / Areas for Improvement?

• Response guidelines;
  Good:
  • Is the Safety Champion confident to challenge?
  • Do they discuss good practice?
  Very Good:
  • Do they know the peoples names?
  • Do they discuss H&S in a balanced manner?
  • Do they discuss why H&S matters to the workforce?
  Excellent:
  • Do operatives and sub-contractors discuss H&S?
  • Do they offer feedback and suggestions on H&S?

• Comments and suggestions from the Auditor.

• Safety Champion Feedback & Suggestions

• Safety Champion to sign

  Sign

• Auditor to sign

  Sign