Observer Information

OBSERVER INFORMATION

  • Observer ID #

  • Select date

  • Number of People Observed:

  • Coached:

  • WORK GROUP

PLEASE EMAIL / SCAN / FAX / TEXT TO:

  • Rodney Smith / WEST - FAX (423) 751-9697 PHONE (423) 653-8320 rjsmith0@tva.gov
    Jeff Burcham / WEST - PHONE (423) 702 1015 jgburcham1@tva.gov
    Wayne Crisp / EAST - FAX (423) 751-9818 PHONE (423) 280-4180 swcrisp@tva.gov
    Lou Johnson / EAST - PHONE (423) 664-2469 lejohnson0@tva.gov

Body Position

1.0 BODY POSITION

  • 1.1 LINE OF FIRE :
    (Does the person place all parts of their body so they will not be pinned, crushed, struck, sprayed or trapped by energy release of any kind?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 1.2 PINCH POINTS :
    (Does the person keep body parts from area between stationary or moving parts that are closing or might close together?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 1.3 EYES ON PATH :
    (Does the person look in the direction they are moving, walking, cycling, operating mobile equipment?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 1.4 EYES ON TASK / HANDS :
    (Does the person keep their eyes on the work being performed?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 1.5 Ascending / DESCENDING :
    (When ascending / descending steep stairs and ladders does the person face stairs / ladder and maintain three-point contact?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

Body Use / Ergonomics

2.0 BODY USE / ERGONOMICS

  • 2.1 LIFTING AND LOWERING :
    (Does the person use legs and keep back straight.)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 2.2 TWISTING :
    (Does the person pivot feet to keep upper torso aligned with legs when doing task?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 2.3 PUSHING / PULLING :
    (Does the person maintain a balanced body position while pushing / pulling?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 2.4 OVEREXTENDED / CRAMPED :
    (Does the person position self to prevent stretching to full arm or body length when performing tasks?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 2.5 RESPONSE TO ERGO RISKS :
    (Does the person deliberately break up the stress by changing positions, moving, stopping activity or stretching?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

Tools / Equipment

3.0 TOOLS / EQUIPMENT

  • 3.1 SELECTION / CONDITION :
    (Does the person select the correct tool for the job?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 3.2 USE :
    (Is the person using the tool as it was designed to be used?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 3.3 Vehicle Selection :
    (Is the person selecting the best vehicle for the job?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

Procedures

4.0 PROCEDURES

  • 4.1 LOCKOUT / TAGOUT :
    (When working on energized equipment does the employee ensure others do not have access to equipment controls and hazard zone(s)?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 4.3 COMMUNICATION :
    (Do people communicating about work being performed and the potential hazards?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

PPE

5.0 PERSONAL PROTECTIVE EQUIPMENT (PPE)

  • 5.1 HEAD :
    (Is appropriate rad protection being worn for the task being performed?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 5.2 EYES AND FACE :
    (Is the appropriate eye and face protection being worn for the task being performed?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 5.3 HEARING :
    (Is hearing protection worn in high noise areas?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 5.5 HAND :
    (Is the appropriate hand protection being worn for the task being performed?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 5.6 BODY :
    (Is the person wearing body protection suitable for the task being performed?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 5.7 FALL :
    (Is the person working at heights wearing body harness? Is it worn correctly?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 5.8 FOOT :
    (Is appropriate foot protection for the work area being worn?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

Work Environment

6.0 WORK ENVIRONMENT

  • 6.1 WALKING / WORKING SURFACE :
    (Is the surface which a task is being performed stable, level, solid, and provide good traction?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

  • 6.2 HOUSEKEEPING / STORAGE :
    (Is the work area kept clear of debris and loose objects?)

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

9.0 OTHER

  • 9.1 OTHER

  • Aware

  • Agree

  • Control

  • WHILE : Describes clearly the task or situation.

  • WAS (At-Risk) : Describes clearly the potential injury.

  • BECAUSE : Describes clearly the barrier or obstacle to doing the behavior safely.

  • SUGGESTION : Are solutions offered.

  • COMMITMENT : What the employee intends to do differently in the future.

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