Title Page

  • STOP Observation Checklist

General Information

  • Safe acts observed

  • Unsafe acts observed

  • Name

  • Date/Time

  • Site

  • Area

  • Shift

  • Time spent on observatiom

  • # of People Contacted

  • # of People Observed

Conditions

Tools and Equipment

  • Right for the Job

  • In Safe Condition

Structures and Work Area

  • Are They Clean

  • Are They Orderly

  • Are They Right For the Job

  • Are They In Safe Condition

Environment

  • Is It Clean

  • Is It Orderly

  • Is It In Safe Condition

Orderliness

  • Standards Available

  • Standards Adequate

Actions

Reactions of People

  • Adjusting Personal Protective Equipment

  • Changing Position

  • Rearranging Job

  • Stopping Job

  • Attaching Grounds

  • Performing Lockouts

Personal Protective Equipment

  • Head

  • Eyes and Face

  • Ears<br>

  • Respiratory System

  • Arms and Hands

  • Trunk

  • Legs and Feet

Positions of People

  • Striking Against or being Struck by Objects

  • Caught In, On, or Between Objects

  • Falling

  • Contacting Temperature Extremes

  • Contacting Electrical Current

  • Inhaling, Absorbing, or Swallowing a Hazardous Substance

  • Repetitive Motions

  • Awkward Positions/Static Postures

Tools and Equipment

  • Right for the Job

  • Used Correctly

  • In Safe Condition

Procedures

  • Available

  • Adequate

  • Known

  • Understood

  • Followed

Orderliness

  • Known

  • Understood

  • Followed

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