Information
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
What is being done well on site?
Recommendations for Improvement
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Note a maximum of six safety observation comments below.
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Date for solution
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By whom?
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Date for solution
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By whom?
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Date for solution
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By whom?
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Date for solution
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By whom?
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Date for solution
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By whom?
Suggested Questions for Team Members
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What do you think your supervisor expects of you regarding safety?
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How do you think safety is managed at the site?
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What areas of safety has your supervisor raised with you? How?
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What has been your safety experience whilst working with us?
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What aspect of safety do you like? Why?
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If you were in change of implementing safety at the site, what changes would you make? How? Why?
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Who do you think is really responsible for developing and maintaining good safety performance at your work site?
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With respect to safety, what part of your job do you worry about most? Why?
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Which tools and/or equipment do you find difficult or hazardous to use? Why?
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What is the biggest threat for causing serious injury in your area?
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Which safety rules do you find difficult to follow? Why?
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Please tell me about the safety training you have received.
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What else, if anything, needs additional safety attention here?
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Have you ever submitted a safety suggestion or safety observation? Why? What were the results of your action?
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Who do you go to when you have a safety problem?
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Tell me about your safety and pre-work briefing meetings. Are they worthwhile? Are they opportunities for two-way communication?
