Was a pre-job safety assessment properly completed for the job being observed?
Each individual observed working with a fall potential greater than six feet was using fall protective equipment or within standard handrails, bucket or basket, or other effective measures to prevent falls?
Is the safety harness and retractable lanyard properly selected, in good condition?
Was the fall protection equipment inspected prior to use?
Were anchorage points suitable to protect against the force of a fall?
Were elevated work platforms used of adequate size and capacity?
Were ladders nonconductive used and observed in good condition?
Were employees climbing ladders (fixed or portable) using three points of contact?
Is there a means of rescue for safely retrieving an employee who use fall restraint devices?
Does the list include all fall protection issues identified this observation?
SAFETY VISIT CARD - CHECKLIST
- Climbing or Standing on Equipment
- Climbing through Equipment (Awkward Position)
- Ascending/Descending (Stairs, Ladders, Platforms)
- Ergonomics (Position/Posture) (Pushing & Pulling)
- Eyes on Task
- Line of Fire (Being Struck By Something)
- Electrical Hazards (Following Safe Work Practices)
- Isolation (Installation of Lockout/Tagout / Try)
- Ergonomics (Lifting/Carrying)
- Line of Fire (Caught Between Something)
- Stepping Over or Under Equipment (Awkward Position)
- Climbing Over Handrails
- Isolation (Securing or Bleeding Off Stored Energy)
- Personnel Protective Equipment (All Needed for Job)
- Vehicles & Driving (Securing Parked Vehicles)
- Vehicles & Driving (Maintaining an appropriate Speed)
- Proper Chemical Handling (Labeling, Storage, Use)
- Tools/Equipment (Correct For Job & Proper Use)
- Tools/Equipment (Good Condition or Properly Stored)
- Are Hazards Controlled (Eliminated/Barricading)
- Reaching through Handrails
- Interaction with Vehicles
- Have Hazards/Risks been Communicated with Others
- Are there any Balance Traction Grip Issues
- Pre Job Safety Assessment Used
- Work at Heights (Protecting from Fall Hazards)
- Confined Spaces (Following Safe Work Practices)
- Work Environment (Hot, Cold, Wet, Etc.)
- Are Safe Work Practices being used?
Select the level of risk: Low, Medium, High
Is there a way to do the job/task "Better" and/or "Safer"?
Follow Up Action required ? (if any, submit action plan)