“Tree Worker Safety”Observer Performance Form

Observes vehicle positioning, placement, parking.

Observes activity taking place (Climbing, Aerial Lift, etc.…)

Observes crew positioning upon arrival.

Parks in a safe place.

Documents Findings.

Attitude towards crew members/Greets crew/ Body language appropriate

Requests JSA, ERP, and all required documentation, and where to find it.

Allows for crew to approach and brief he/her on job plan break down.

Asks about the job plan break down.

Observes and identifies over all activity/activities taking place.

Observes Correct use of PPE.

Observes aerial rescue kit placement.

Observes Fire Tool placement in relation to the site and work being performed.

Observes tie in points (tree and Lift).

Observes 2 points of attachment while using cutting tools.

Observes JSA matches jobsite analysis.

Observes Correct use of cutting tools (Handsaw, Pruner, Chainsaw)

Observes spotter position in relation to climber/operator aloft.

Observes 2 points of attachment while using cutting tools(In Tree).

Observes company policies and safe work practices are being followed.

Observes and identifies Items at risk

bserves company policies are being followed.

Stops Crew when Safe?

Addresses safety concern?

Makes crew aware of findings or exceeds?

References to specific training document, Policy, or ANSI Z133-2017 standard regarding items identified?

Communicates concerns to crew?

Does he/she refer on where to find specific policies and safe work procedures?

Explains the potential hazards associated with the items identified?

Explains or demonstrates proper way to perform task at risk?

Does crew engage in training or demonstration?

Documents finding on observation platform?

Documents training on data platform? Or sign in sheet?

Contacts crew supervisor regarding issue?

Assigns Action Item on observation platform for follow up with crew and crew supervisor?

Contacts his/her supervisor to report issue?