Information

  • Name of Employee

  • SAP number

  • Grade

  • Department

  • Location
  • Conducted on

  • Assessor

Safety Messaging

  • What is the safety tip of the day?

  • Do you have pre-shift meetings and is safety message included?

  • Do you have monthly safety meetings?

  • Why is safety important to you?

  • Why is safety important to your supervisor?

PPE

  • When have you been trained on the proper use of PPE?

  • Do you know what the proper PPE is for your job?

PPE Observation

  • Is your co-worker wearing proper PPE?

  • Can employee demonstrate proper use of PPE?

Fire safety

  • Can you tell me how to use a fire extinguisher?

  • What is your role in case of a fire?

Emergency response

  • Do you know how, and to whom you would report an emergency?

  • Could you tell me what you would do if anyone was injured?

  • Tell me if you or anyone you work with has experienced an injury?

Safety recognition

  • Have you or anyone else been recognized for safe behavior recently?

  • Tell me some things you would do to help us achieve our goal where NOBODY GETS HURT TODAY?

  • Employee safety recommendations.

  • I have been trained and reviewed on Safety. I also understand that I am to report any accident to the supervisor and office immediately.

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.