Information

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

1. STOP - Engage your Mind before your Hands.

  • Am I trained, competent and authorised?

  • Am I fit to perform the task? (aware, rested, alert)

  • Do I understand the task? (Is the task planed?)

  • Is there a current Procedure or SWP for the task?

  • Can the task be done without a permit?

  • Am I using the appropriate tools/PPE for the task?

  • Do I know what to do in an emergency?

IF NOT STOP AND CHECK WITH SUPERVISOR OR DEPUTY

2. LOOK - At the workplace and find the hazards

  • 1. Does the task involve hazardous forms of energy? If "Yes" complete assessment!

  • 2. Is Isolation required? If yes complete assessment!

  • 3. Can I slip, trip or fall? If "At Risk" complete assessment!

  • 4. Have I completed basic housekeeping in my work area? If "At Risk" complete assessment!

  • 5. Can I get caught in or between anything? If "At Risk" complete assessment!

  • 7. Have I planned the communication for the task? If "At Risk" complete assessment!

  • 8. Will I come in contact with mobile plant/moving equipment? If "At Risk" complete assessment!

  • 9. Do I need to barricade or block my work area? If "At Risk" complete assessment!

  • 10. Can I get hurt and/or introduce hazards to others? If "At Risk" complete assessment!

ASSESS: The effects of the hazards on people, property and environment

  • PROCEED WITH TASK IF "Safe" TO DO SO!

MANAGE: With effective controls and by advising others

  • If you are unable to perform the task safely, contact your supervisor.

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.