Safety Observation Walk Checklist

• Division

• Conducted on

  Date

• Document No.

• Prepared by

• Location
  Address

• Personnel

Warehouse location

• Pier or Dock (example North dock/ Pier 8)

Work Areas

• Do you wish to observe work areas on this safety walk?

  Yes

  No

  N/A

• OTR Drivers standing in designated area ( Yellow box)

  Compliant

  Non-Compliant

  N/A

• Warehouse floor (free of debris and obstructions)

  Yes

  No

  N/A

• Egress points(Doors, Refrigerator openings, Fire exits) clear and accessible

  Yes

  No

  N/A

• Forklift operators traveling with forks 2-4 feet above the ground

  Compliant

  Non-Compliant

  N/A

• Cooler Boxes Curtains clear and clean for operational view

  Yes

  No

  N/A

• Fire Extinguishers accessible

  Yes

  No

  N/A

Process Observation

• Horn used at all intersections, doors and entry ways

  Yes

  No

  N/A

• Distracted Driving- operators using personal devices while operating equipment

• Operators wearing seat belts

  Yes

  No

  N/A

• Operators driving in reverse while carrying product

  Compliant

  Non-Compliant

  N/A

• No headphones are in use while operating equipment

  Compliant

  Non-Compliant

  N/A

• Forklift operators traveling at a safe speed

  Yes

  No

  N/A

• Operators following traffic patterns? Staying to the right while going in and out of the boxes

  Yes

  No

  N/A

Loading/Unloading Process Safety observation

• OTR Truck Wheel Chocked

  Yes

  No

  N/A

• OTR trailer floor safe to enter before loading

  Yes

  No

  N/A

• Forklift operator using horn while exiting trailer

  Yes

  No

  N/A

• Forklift operator only enters trailer with OTR driver present

  Yes

  No

  N/A

Put away and Picking Process Safety Observation

• Operator loads rack in correct order

  Compliant

  Non-Compliant

  N/A

• Operators should take pallets from Top to Bottom

  Compliant

  Non-Compliant

  N/A

• Keep forks tilted for product to rest on back rest/mast

  Compliant

  Non-Compliant

  N/A

• Operator does not turn while load is elevated

  Pass

  Fail

  N/A

• Operator does not putaway into damage racks

  Compliant

  Non-Compliant

  N/A

• Operator does not putaway damaged pallets

  Compliant

  Non-Compliant

  N/A

Safety Observation and Question

• What was the safety talk topic today

• PPE beginning worn while in the warehouse by personnel and OTR's

  Yes

  No

  N/A

• Any safety issues that have been observed today/ if so what

• Damages reported and put in to FMX for repair

  Yes

  No

  N/A

People Safety

• Do you wish to check supervisors/ Management safety knowledge at this inspection?

  Yes

  No

  N/A

• Approach at least one team member and record their responses to the following. Make clear this is not an assessment of the team member themselves, but rather the safety procedures on site.

Division Leaders

• Is the supervision/management able to describe the correct process to follow in an emergency situation?

  Yes

  No

  N/A

• Was there any near misses observed if so what should be done?

• If any Incident it should be reported with in 48hrs

  Yes

  No

  N/A

• Team member signature (to verify this interview took place NOT to assess their safety knowledge)

  Sign

Sign Off

• Signature of Supervisor

  Sign

• Signature of Safety Division

  Sign