Title Page

  • FBonaobra - Technical Assessment

  • SAFETY INTERACTION CHECKLIST

  • Client / Site

  • Conducted on

  • Franz Bonaobra - Technical Assessment

  • Location
  • Personnel

GENERAL

TASK DESCRIPTION

  • Provide a brief summary of your task.

  • Provide the main risks & hazards associated with this task.

  • What controls do you have in place and do you think they are enough?

  • What are the current health and safety issues your department is experiencing?

  • How are these issues / concerns being addressed?

  • On this job, do you feel there may be a need to deviate from standard procedure?

BODY POSITION

BODY POSITION

  • Are the employees under line of fire?

  • Do employees have safe view of the path on site (eyes on path)?

  • Are the employees safe when viewing the task (eyes on task)?

  • Do ascending or descending structures prohibit safe positioning on site?

  • Do pinch points or rotating objects guarantee safety when working on site?

MANUAL HANDLING / ERGONOMICS

MANUAL HANDLING / ERGONOMICS

  • Are employees capable of lifting or lowering site materials?

  • Are employees capable of twisting, pushing or pulling site materials?

  • Employee posture is vital and should not be overextended nor cramped.

  • Ergonomic risks are part of work and employers & workers should always be cautious.

TOOLS & EQUIPMENT

TOOLS & EQUIPMENT

  • Employee tools & equipment selection should always be at the highest standards.

  • Tools & equipment should always be maintained in an orderly condition.

  • Are tools & equipment used properly on site?

  • Are there safeguards, barricades & delineation maintained for the tools & equipment on site?

PROCEDURES

PROCEDURES

  • Employees should have pre-start, take-5 & JHA procedures on every task.

  • Task procedures should have isolation or tag-out protocols in effect.

  • Implemented hazard communication programs should be in effect at all times.

  • Permit procedures are done with strict compliance.

  • Light vehicle operations should be tasked safely among workers.

  • Surface mobile equipment should be, at all times, operational and safe.

  • Are the lifting equipments safe to use on site?

  • Explosive materials should be maintained safely at all times.

  • Are there protocol for workers who are working at heights?

  • Safety & security is a priority for those who are working on a confined space entry.

WORK ENVIRONMENT

WORK ENVIRONMENT

  • Walking or working surfaces should be safe for workers at all times.

  • Work site compliance with housekeeping or storage protocols.

  • Work site lighting should be maintained at all times.

  • Are workers safe from extreme temperatures or UVR exposure?

  • Liquid transfer, distribution & uncontrolled discharge should be observed & handled diligently.

  • Hazardous materials, noise & dust should be controlled properly.

PPE

PPE

  • Are workers trained with the basic PPE protocols?

  • Task specific PPE should be well-accustomed to all workers.

FATIGUE MANAGEMENT

FATIGUE MANAGEMENT

  • Are workers given enough time to manage health & fatigue during their work on site?

TRAINING

TRAINING

  • Employee training should be, at all times, recorded.

  • Do employees receive additional competency training for additional tasks?

POSITIVE FEEDBACK NOTES

POSITIVE FEEDBACK NOTES

  • What were the safe behaviors you observed?

  • What did you like about them?

AT-RISK BEHAVIOR NOTES

  • What WAS/WERE the at-risk behaviors observed?

  • Was the employee AWARE of the at-risk behaviors?

  • Does the employee AGREE that it is/was at-risk?<br>

  • What is the employee’s REASON behind working at-risk?

  • What is an agreed on suggestion for a SOLUTION?

IMMEDIATE ACTIONS

  • What immediate actions are required to provide corrective actions within the workplace?

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.