Temporary Staffing - Daily Site Safety Evaluation - Zurich

• Conducted on

  Date

• Prepared by

• Location
  Address

• (Note: To be completed on all client locations within 24 hours of the occurrence of a safety incident)

• Company (Client) Name:

• Date of Walkthrough:

  Date

• Department(s) evaluated?

  Yes

  No

  N/A

• **To be completed daily a minimum of once per shift. Any hazards found should have a comment in the “Action Taken” section.**

• Action Taken

Observations

• Is the work environment clean and sanitary? (ex: debris, trash, etc )

  Yes

  No

  N/A

• Are there any trip hazards visible? (ex: cords, wires, debris, trash, etc )

  Yes

  No

  N/A

• Is the associates work area well organized?

  Yes

  No

  N/A

• Are there any broken or damaged pallets in the area?

  Yes

  No

  N/A

• Did you observe any broken equipment being used?

  Yes

  No

  N/A

• Are there any other general housekeeping concerns in the area?

  Yes

  No

  N/A

• Were any associates on PIT observed practicing unsafe behaviors? If so, coach immediately

  Yes

  No

  N/A

Associate Behavior

• Were any associates observed practicing unsafe behaviors? If so, please coach immediately

  Yes

  No

  N/A

• Did any associates have any safety complaints or concerns? If so, escalate to Account Manager &

  Yes

  No

  N/A

Safety

• Completed by:

• Date:

  Date