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Site Safety Observation Record
Site Safety Observation Record
Anonymous

Site Safety Observation Record Checklist

Version 1. Current Recommended Template

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Audit

Observed Safety Hazards & Risks Categories (tick where applicable)
PROCEDURE
  • Selection
  • Condition
  • Use
  • Current Tags - Electrical
  • Current Tags - Scaffolding
  • Current Tags - Rigging

Is Action Required

PPE
  • Head
  • Eyes
  • Face
  • Hearing
  • Respiratory
  • Hand
  • Hand
  • Body
  • Feet

Is Action Required

WORK ENVIRONMENT
  • Housekeeping
  • Barricading
  • Exclusion Zones
  • Thermal Control
  • Storage
  • Facility Conditions
  • Working Conditions
  • Confined Space

Is Action Required

TOOLS / EQUIPMENT
  • Selection
  • Condition
  • Use
  • Current Tags - Electrical
  • Current Tags - Scaffolding
  • Current Tags - Rigging

Is Action Required

BODY USE / POSITION
  • Line of Fire
  • Lifting
  • Pushing / Pulling
  • Carrying
  • Walking
  • Climbing
  • Posture

Is Action Required

MOBILE EQUIPMENT
  • Condition
  • Use
  • Enter / Exit
  • Pedestrian Segregation

Is Action Required

Hazard / Risk observed not previously defined
Hazard / Risk Identified

Hazard / Risk

Commendable Safe Behaviour Observed

Safety Inspection Completion Sign Off

The Officer completing this Safety Observation must ensure that the final report is sent through to Safety Services for recording of Hazards and required follow up Actions.

Observation Completed by

The Site Representative accepts the findings of this Safety Observation and if required shall ensure that any corrective actions indentified during this Observation shall be actioned immediately.

Site Representative (if relevant)
Site Safety Observation Record
Anonymous

Site Safety Observation Record

Version 1. Current Recommended Template

Use this Digital Checklist
Download as PDF
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.

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