Title Page

  • Location
  • Completed by

  • Conducted on

  • Area where Audit is done

  • Shift

Safe Acts & Discussions

  • Who (E, M, C)

  • What, Where - Was behaviour reinforced

  • Person(s) carrying out the positive Safe Act

  • Category

  • Any more Safe Acts & Discussion?

  • Safe Acts & Discussion
  • Who (E, M, C)

  • What, Where - Was behaviour reinforced

  • Person(s) carrying out the positive Safe Act

  • Category

UnSafe Acts & Discussions

  • Who (E, M, C)

  • What, Where - Outcome of Discussion (Actions Taken)

  • Actions Completed by Or Actions Deferred Until

  • Category

  • Any more UnSafe Acts & Discussion?

  • UnSafe Acts & Discussion
  • Who (E, M, C)

  • What, Where - Outcome of Discussion (Actions Taken)

  • Actions Completed by Or Actions Deferred Until

  • Category

Safety Management Audit Training (Behavioural Coaching) Progress report

  • Deferred Action Taken

  • Select date

  • By Whom

  • Any more Deferred Action Taken

  • Deferred Action Taken
  • Deferred Action Taken

  • Select date

  • By Whom

Workplace Safety Observation (Unsafe Conditions)

  • Guidance Notes: During a behaviour coaching session the focus will be on the acts of the manager or the frontline employees who are working within a given area, however it is possible, during the coaching session, that you will also observe unsafe conditions. These cannot be overlooked and must be brought to the attention of the Work Area Managers.

  • Location

  • Observed UnSafe Conditions

  • Suggested Countermeasure

  • Select date

  • By whom

  • Observed: Unsafe Conditions

  • Unsafe Conditions
  • Location

  • Observed UnSafe Conditions

  • Suggested Countermeasure

  • Select date

  • By whom

  • Once the SMAT is completed please email it to your relevant managers

  • The coach should leave a copy of the SMAT with the coaches. If no photocopy facilities are available at the office send a copy of the report to the coaches on return to your office.

  • To complete the process the coach must load the contents of the SMAT on the national Sharepoint site.

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.