Safety Contact Form OHS Form F28-01

• The purpose of a safety contact is to improve the standard of health and safety in the workplace and demonstrate genuine concern for people's welfare.
  Focus on good practices as well as unsatisfactory practices.
  Discuss unsatisfactory practices with the person and gain a commitment to change.
  Praise good practices abc biting them yo the attention of a manager/supervisor.

• Document No.

• Site

• Department

• Contact made by:

• Number of people observed:

• Conducted on

  Date

• INSTRUCTIONS
  
  1. Document the observation
  2. Select the appropriate Contact Category
  3. Select the appropriate Class of Observation
  4. Document the "Action Taken"
  5. Document the "By Whom"
  6. Once completed all observations, please click the "finish audit" button in the bottom right hand side of the page.
  
  Provision has been made for up to 4 separate observation, if more are made, please commence a new Safety Contact.

Observations

• Tap here to enter observation

• Contact Category

• POP - Position of people in relation to hazards (ie. is the position of the person placing them at risk of being stuck, trapped, entangled etc?)

• WP - Work in Practice (does the posture, type & number of movements, types of loads, environment place the person at risk)

• PPE - Personal Protective Equipment ( Is the correct type of PPE, in good condition, being worn correctly)

• PRO - Procedure (is there a current procedure, adequate for the task, which has been communicated to and complied with)

• Class of Observation

• SA - Safe Act - persons are observed to be working in a safe manner

• UA - Unsafe Act - an obviously unsafe act which is placing a person or others at risk.

• SC - Safe Condition - the work practice, procedure, use of PPE & tools, and general housekeeping are of an acceptable standard with no apparent tick to any person.

• UC - the dork practice, procedure, use of PPE & tools, and general housekeeping are of an unacceptable standard and May place a person at risk.

• Action taken:

• By Whom:

Observations

• Tap here to enter observation

• Contact Category

• POP - Position of people in relation to hazards (ie. is the position of the person placing them at risk of being stuck, trapped, entangled etc?)

• WP - Work in Practice (does the posture, type & number of movements, types of loads, environment place the person at risk)

• PPE - Personal Protective Equipment ( Is the correct type of PPE, in good condition, being worn correctly)

• PRO - Procedure (is there a current procedure, adequate for the task, which has been communicated to and complied with)

• Class of Observation

• SA - Safe Act - persons are observed to be working in a safe manner

• UA - Unsafe Act - an obviously unsafe act which is placing a person or others at risk.

• SC - Safe Condition - the work practice, procedure, use of PPE & tools, and general housekeeping are of an acceptable standard with no apparent tick to any person.

• UC - the dork practice, procedure, use of PPE & tools, and general housekeeping are of an unacceptable standard and May place a person at risk.

• Action taken:

• By Whom:

Observations

• Tap here to enter observation

• Contact Category

• POP - Position of people in relation to hazards (ie. is the position of the person placing them at risk of being stuck, trapped, entangled etc?)

• WP - Work in Practice (does the posture, type & number of movements, types of loads, environment place the person at risk)

• PPE - Personal Protective Equipment ( Is the correct type of PPE, in good condition, being worn correctly)

• PRO - Procedure (is there a current procedure, adequate for the task, which has been communicated to and complied with)

• Class of Observation

• SA - Safe Act - persons are observed to be working in a safe manner

• UA - Unsafe Act - an obviously unsafe act which is placing a person or others at risk.

• SC - Safe Condition - the work practice, procedure, use of PPE & tools, and general housekeeping are of an acceptable standard with no apparent tick to any person.

• UC - the dork practice, procedure, use of PPE & tools, and general housekeeping are of an unacceptable standard and May place a person at risk.

• Action taken:

• By Whom:

Observations

• Tap here to enter observation

• Contact Category

• POP - Position of people in relation to hazards (ie. is the position of the person placing them at risk of being stuck, trapped, entangled etc?)

• WP - Work in Practice (does the posture, type & number of movements, types of loads, environment place the person at risk)

• PPE - Personal Protective Equipment ( Is the correct type of PPE, in good condition, being worn correctly)

• PRO - Procedure (is there a current procedure, adequate for the task, which has been communicated to and complied with)

• Class of Observation

• SA - Safe Act - persons are observed to be working in a safe manner

• UA - Unsafe Act - an obviously unsafe act which is placing a person or others at risk.

• SC - Safe Condition - the work practice, procedure, use of PPE & tools, and general housekeeping are of an acceptable standard with no apparent tick to any person.

• UC - the dork practice, procedure, use of PPE & tools, and general housekeeping are of an unacceptable standard and May place a person at risk.

• Action taken:

• By Whom:

• Tap to Input Name, then tap on pen to sign

  Sign