Safety Interaction - Safe Act Observation

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Safe Act Observation ( SAO)

• Safety interaction intended to promote safe work practices

Who, What, Where

• Employee Name ( optional)

• Department

  Parts

  Service - GR

  Service - Components

  Administration

• Time of safety interaction?

  Date

• Task?

1.0 - Task review

• Take 5 completed for this specific task?

  Yes

  No

  N/A

• Has the task changed from the original task scope?

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

• Do you have gloves available?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

2.0 - Work area Safety

• 2.1 - Floor surfaces clear and uncluttered?

  Yes

  No

  N/A

• 2.2 - Entry and walkways kept clear?

  Yes

  No

  N/A

• 2.3 - No damaged hand tools in use?

  Safe

  At Risk

  N/A

• 2.4 - No damaged power tools in use?

  Safe

  At Risk

  N/A

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

  Yes

  No

  N/A

3.0 - Storage

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 3.3 - Floors around racking clear of rubbish?

  Yes

  No

  N/A

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

  Safe

  At Risk

  N/A

4.0 - Fire Prevention

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

  Yes

  No

  N/A

• 4.4 - Exits clear of obstructions?

  Yes

  No

  N/A

• 4.2 - Where is your nearest fire extinguisher located?

  Yes

  No

  N/A

• 4.3 - Is fire Extinguisher clear of obstructions?

  Yes

  No

  N/A

5.0 - First Aid Facilities

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

6.0 - Chemical Safety

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

  Yes

  No

  N/A

• - All containers labelled correctly?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• - If required, is PPE available?

  Yes

  No

  N/A

• - Is adequate ventilation provided?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

7.0 Contamination Control

• Name 3 sources of debris generating tools

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

Employee comments or feedback?

• Enter feedback here:

Auditors comments

• Enter comment here (if applicable)