Title Page

  • Conducted on

  • Prepared by

  • Location

This information MUST be submitted no later than 1000 each Friday. Please submit prior to this if you will be on leave or unavailable.

  • How are you feeling on a 1-10 Scale?

Re-Active Workload

  • How many Actions (your own action) have you completed this week?

  • How many RTC investigations have you or your stakeholders completed this week?

  • How many Basic Level investigations have you or your stakeholders completed this week

  • How many Standard Level investigations have you or your stakeholders completed this week

  • If you were required to complete an investigation yourself, please name stakeholder and investigation level below.

  • 'Late Complete' investigations?

  • 'Late Complete' Actions?

  • Extended Investigations

  • Process aligned investigations within D5

  • Process aligned actions within D5

  • Time spent facilitating TapRoot (hrs)

Pro-Active Workload

  • How many ESDs have you had in the past week?

  • How many Hazard/Near Miss reports have you recorded in the past week?

  • How many site visits have you completed this week? (to engage with Field Force)

  • Which processes have you visited?

  • Strategy (hrs)

  • Overall Strategy Status

  • Meeting Time (hrs)

  • Travel (hrs) DO NOT INCLUDE COMMUTING

  • Cascade Production (hrs)

  • non-productive / available time: e.g. standby rest time, appointments, holidays, training. (Please add hours and reason)

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.