STARR Information


Task Observed

Observed on
No. of People Observed

Actions of people

At risk actions

Appropriate PPE

At risk PPE

Equipment Use

At risk equipment use

Body Position and Use

At risk body positioning

Adherence to Procedures

At risk procedure

Safe acts observed

Unsafe acts observed

Sign off
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.