Tray making workspace observation tool

• Document No.:

• Conducted on:

  Date

• Completed by

• Facility / site

• Location
  Address

Personal Protective Equipment (PPE)

• Safety footwear - are workers wearing safety footwear in designated tray making areas

  Meets Standard

  Needs Improvement

  Not Applicable

• High visibility

  Meets Standard

  Needs Improvement

  Not Applicable

• Eye protection

  Meets Standard

  Needs Improvement

  Not Applicable

• Hearing protection

  Meets Standard

  Needs Improvement

  Not Applicable

• Gloves

  Meets Standard

  Needs Improvement

  Not Applicable

• Hair nets

  Meets Standard

  Needs Improvement

  Not Applicable

Environment

• Workspace TMP displayed in area

  Yes

  No

  N/A

• Forklift movement observed in line with TMP

  Yes

  No

  N/A

• Floors clear of trip hazards

  Yes

  No

  N/A

• Tools stored correctly

  Yes

  No

  N/A

• Lighting adequate for task required

  Yes

  No

  N/A

• Food or drink observed at machine or in area

  Yes

  No

  N/A

• Inwards - flat product to machine flows well and inline with TMP

  Yes

  No

  N/A

• Outwards - assembled product from machine flows well and in line with TMP

  Yes

  No

  N/A

Machine

• 2 x staff per machine

  Yes

  No

  N/A

• All guards in place and secured

  Yes

  No

  N/A

• Oil / air / glue - no leaks on machinery

  Yes

  No

  N/A

• SOPs, MSDS and log books at machine

  Yes

  No

  N/A

• Air lines and electrical cables positioned safely

  Yes

  No

  N/A

• Machine clean and free of excessive cardboard waste

  Yes

  No

  N/A

• Lid on glue bucket and scoop inside

  Yes

  No

  N/A

• Additional comments/observation

Observation

• Additional comments

  Safe

  At Risk

  N/A

• Add observations/comments here.

• I hereby certify that all information is accurate and that an actual inspection was conducted.

• Completed by Name & Signature

  Sign