Title Page

  • Unit Inspected:

  • Building
  • Conducted on:

  • Prepared By:

Work Center/ Shop Supervisor Responsibilities 91-202 Chapter 1

  • Q1. Are Hazards identified, eliminated, or mitigated to an acceptable level IAW DoD 6055.01, 91-202, and 91-204 para 1.3.4.?

  • Assign RAC Code

  • Q2. Are AF Form 457s or cross references for electronic means available to all personnel? 4.3 Commonly visited areas such as break rooms, training rooms, debrief rooms and safety bulletin boards are recommended.

  • Assign RAC Code

  • Q3. Do supervisors or individuals understand their responsibility to take immediate action to mitigate or eliminate crititcal/imminent danger hazards to protect personnel or property within their area of responsibility? 4.3.2.

  • Assign RAC Code

  • Q4. Are hazards reported to the applicable safety office? 4.3.3.

  • Assign RAC Code

  • Q5. Do supervisors Understand and enforce the safety and health standards that apply to their areas, operations and operations involving their subordinates. Demonstrate knowledge of their roles and responsibilities with relation to risk management and mishap prevention?

  • Q6. Do supervisors use RM techniques to analyze work environment and job tasks for hazards and conduct JHAs to determine potential hazards for tasks not governed by other official guidance?

  • Q7. Do supervisors provide and document work area specific safety, fire protection and health onthe-job training to all Air Force military and civilian employees before assigning them duty tasks requiring this specific training?

  • Q8. Do supervisors review work processes annually, when new tasks or equipment are added, or when existing tasks change, whichever comes first?

  • Q9. Do supervisors exercise control over job tasks to ensure personnel follow all precautions and safety measures, including the proper use of PPE?

  • Q10. Do supervisors report all mishaps that occur on duty and all off duty mishaps involving assigned military personnel, and related subsequent Airmen absences to the supporting safety office?

  • Q11. Are actions taken to promptly eliminate hazards, correct defeciencies, and ensure any hazards with an AF Form 1118 are added to JSTO and train employees IAW JSTO guidance on changes?

  • Q12. Do Workcenter/shop supervisors, USRs and ADWSRs conduct and document monthly spot inspections? 3.7

  • Individual Responsibility.

  • Q13. Do individuals hand-carry or electronically transfer safety training documentation, provided by previous supervisor, as specified in paragraph to the new supervisor when deploying or transferring to another Air Force position/location?

  • Q14. Does the involved/injured personnel's supervisor complete AF Form 978 for mishap reporting criteria outlined in DAFI 91-204, route it through the commander, and return it to the installation safety office within five (5) workdays following notification? 1.4.4.


  • Safety Staff:

  • Supervisor

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