Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Safe Act Observation ( SAO)

  • Safety interaction intended to promote safe work practices

Who, What, Where

  • Employee Name ( optional)

  • Department

  • Time of safety interaction?

  • Task?

1.0 - Task review

  • Take 5 completed for this specific task?

  • Has the task changed from the original task scope?

  • No sharp edges on task at hand or in area?

  • Do you have gloves available?

  • Know where to find a JHA ( blank or previously completed)?

2.0 - Work area Safety

  • 2.1 - Floor surfaces clear and uncluttered?

  • 2.2 - Entry and walkways kept clear?

  • 2.3 - No damaged hand tools in use?

  • 2.4 - No damaged power tools in use?

  • 2.5 - Work height correct for the type of work and the employee?

3.0 - Storage

  • 3.1 - Materials stored in racks or baskets wherever possible?

  • 3.2 - Method of Storage designed to minimise lifting problems?

  • 3.3 - Floors around racking clear of rubbish?

  • 3.4 - General condition of racks and pallets in use?

4.0 - Fire Prevention

  • 4.1 - Evacuation plan display location and evacuation process understood by employee?

  • 4.4 - Exits clear of obstructions?

  • 4.2 - Where is your nearest fire extinguisher located?

  • 4.3 - Is fire Extinguisher clear of obstructions?

5.0 - First Aid Facilities

  • 5.1 - Employee aware of location of first aid cabinet?

  • 5.2 - Who or where are first aid officers located? If unsure, how would you find out?

6.0 - Chemical Safety

  • - Do you know where Material Safety Data Sheets ( MSDS) are available from, for all chemicals on site?

  • - All containers labelled correctly?

  • - Are Risk assessments completed for use of hazardous substances?

  • - If required, is PPE available?

  • - Is adequate ventilation provided?

  • - Are eye washes and showers easily accessed? Location?

7.0 Contamination Control

  • Name 3 sources of debris generating tools

  • Can plastic caps be used to stop a leaking hose during repair?

  • Should spills be cleaned up within an hour of the spill or leak occurring?

  • What is the current branch star rating? And what is our goal.

Employee comments or feedback?

  • Enter feedback here:

Auditors comments

  • Enter comment here (if applicable)

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.