Information

  • Document No.

  • Company being observed?

  • Area/Location of Observation?

  • Weather conditions?

  • Select date

Visual Focus

  • Eyes on task

  • Eyes on walking path

  • Acting to correct an observed risk

Body Position

  • Hands safe

  • Out of "line of Fire"

  • Avoid crush or pinch points

  • Maintaining balance, traction and grip

Manual Material Handling

  • Bend at the knees, not waist

  • Hold load close to body

  • Turn at feet, not the waist

  • Avoid over-reaching

  • Choose pushing instead of pulling

  • Lifting within power zone

  • Single person lifts < 50 lbs.

Organization & Housekeeping

  • Clean work area and safe path of travel

  • Safe staging of materials

Elevated Work

  • Adhere to ladders last policy

  • Proper Anchor point and use of fall-arrest equipment

  • Ladder - 3 points of contact or personal fall protection

  • Observer Name(s)

  • Observer Name(s)

  • Observer Name(s)

  • Observer Name(s)

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.