Title Page

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  • Safety Observation Record

  • Your Safety Observation Record
    Thank you for taking the trouble to take a look at this app.
    You might ask 'What is a near miss or close call?' The simply answer is, if you think it is a near miss then it is. It's your opinion that matters.
    So, why is it important that we consider acting upon what we see?
    Well, there are a number of benefits, both for those working on site and for their employers. Firstly, if you see something happening that has the potential to cause harm then action can be taken, there and then, to stop it before any real damage is done. If it is followed up with some kind of report then it can be investigated and changes made that may prevent it happening again.
    But we don't just want to hear about poor practice. There are a lot of really good things happening on sites that we don't necessarily get to hear about, unless you take the trouble to tell us.
    Ultimately everybody benefits from your observations, so on behalf of everyone I would like to say "Thank You" for this report.

  • Please enter the name of the project where your observation was made

  • You must answer this question. This needn't be the official job title, just provide enough information to enable us to get to site if necessary.

  • If you know the project's job number please add it here

  • If you know this then including it will save us some time when recording the observation.

  • Please enter the date and time the observation was made

  • You must answer this question. Drag each column up or down.
    This information will help us to create a more accurate picture of the circumstances relating to the observation.

  • Do you consider what you saw as GOOD or POOR practice?

  • You must answer this question. Tap either 'Good' or 'Poor'. It may seem obvious to you but it isn't always so clear-cut. Please let us know what you think.

  • Please tell us how what you have seen has been reported. You can select as many as you want from the drop down list.

  • You must answer this question. Tap as many as apply.
    It is useful for us to know whether you have made others aware of the circumstances.

  • Please describe what you saw. Include as much detail as possible. The more information you can provide the more accurately we can assess the circumstances. Where on the site did this occur? What was happening at the time? How many people were involved? (You do not need to gives names.) What was your particular concern?

  • You must answer this question.

  • If you have any photographs they can be attached here.

  • You can either use the camera on your device to take a picture, or you can add a picture stored on your device.
    In most cases pictures can give far more information about a situation than words, and provide a lasting record of what you are telling us about.

  • If you have any suggestions about how your observation should be addressed please add them here.

  • Your thoughts about what you have seen are important to us. Please tell us how you think it should be dealt with.

  • Please select which ONE of the following categories you feel is most appropriate.

  • You must answer this question. Please select just ONE of the categories.

  • Optional field. Please add your name and contact details. Doing so will enable us to clarify points we aren't clear about and also let you know what action has been taken.

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.