Information
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Safety Behavior Check
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Client / Site
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Conducted on
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Prepared by
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Functional Area Observed
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# Personnel Observed
Service Type
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- Food Services
- Patient Transport
- Facilities Management
- Environmental Services
- Mail Room / Lab
- Construction
- Laundry
Safety Behavior Check
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Pick up spills ASAP
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Wash hands to prevent illness
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Safe ladder use - not using chairs
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Avoid shortcuts
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Employees eyes on task
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Practicing good housekeeping
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Employees wear seat belt when driving
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Always use right procedure for the job
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Keep electrical cords out of aisles and walkways
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Employees know assembly point
Safety Management Observations
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Recommendation #1
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Recommendation #2
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Recommendation #3