VIP SAFETY OBSERVATION

• The approach by the observer is to demonstrate genuine concern for the worker's health and safety. Observers should focus on good practices as well as identifying unsatisfactory practices. Observations should be short and take no more than 15 min's.
  Review past observations for the area of work, and previous actions. Use consultation and discussion to identify action and gain commitment to change from workers.
  

• Observer 1 Name:

• Observer 2 Name:

• Site:

• Work Area Observed:

• Conducted on

  Date

• Form completed by:

• REMEMBER: THE STANDARD YOU SET IS THE STANDARD YOU GET.

TASK OBSERVATION

• What task / activity is being observed?

  Select Manual Handling Working with Chemicals Operating Machinery PME Operation Welding / Hot Work Working at Height Using Ladders Using EWP Working in Isolation Confined Space Work Using Compressed Air Stacking on a Machine Feeding a Machine Cleaning Maintenance on a Machine Other

  • Manual Handling
  • Working with Chemicals
  • Operating Machinery
  • PME Operation
  • Welding / Hot Work
  • Working at Height
  • Using Ladders
  • Using EWP
  • Working in Isolation
  • Confined Space Work
  • Using Compressed Air
  • Stacking on a Machine
  • Feeding a Machine
  • Cleaning
  • Maintenance on a Machine
  • Other

• Enter Details

• PHOTO IF REQUIRED

  Media

PERSONAL SAFETY

• Are the workers being observed working in a safe work place?<br>Consider proximity to mobile equipment, exertion and loads lifted, slip and trip hazards, exposures to heat and fumes or proximity to energy sources and task repetition

  SAFE

  AT RISK

  N/A

• Enter Reason

  Select Struck by or striking against an object Caught between or squashed Body posture, twisting turning Straining, pushing or pulling Over exertion / excessive force Two man lift required Slip / Trip / Fall hazard Exposure to heat / gas / fume Extreme temperatures Exposure to electrical current Other

  • Struck by or striking against an object
  • Caught between or squashed
  • Body posture, twisting turning
  • Straining, pushing or pulling
  • Over exertion / excessive force
  • Two man lift required
  • Slip / Trip / Fall hazard
  • Exposure to heat / gas / fume
  • Extreme temperatures
  • Exposure to electrical current
  • Other

• Enter details

STANDARD WORKING PROCEDURES

• Are working procedures adhered too?<br>Consider if procedures are not clear, not known , not followed , is a permit to work required, is isolation correct. Is an SOP available and being followed.

  SAFE

  AT RISK

  N/A

• SELECT REASON

  Select Procedure not known Procedure misunderstood Procedures not followed SOP not available (if applicable) Permit to work not being used (if required) Stop & Think not applied (if applicable)

  • Procedure not known
  • Procedure misunderstood
  • Procedures not followed
  • SOP not available (if applicable)
  • Permit to work not being used (if required)
  • Stop & Think not applied (if applicable)

SAFE WORK PRACTICE

• Are safe work practices being adhered too?<br>Consider body posture , twisting , turning , straining , pushing or pulling loads. Should loads be lifted by two workers , Locks and danger tags used. Isolations correct . Worker is observant and careful when walking .

  SAFE

  AT RISK

  N/A

• Select reason

  Select Standard practice not adequate established and maintained Isolation Locks and or Danger Tag

  • Standard practice not adequate
  • established and maintained
  • Isolation
  • Locks and or Danger Tag

HOUSEKEEPING

• Rate the housekeeping in the area Consider waste , tidiness, Is the workplace orderly . Are tools and equipment stored correctly, Are there hoses around whioch could be a trip hazard

• If the rating is less than 7, enter details

  Select Trip hazards evident Debris evident Accumulated waste

  • Trip hazards evident
  • Debris evident
  • Accumulated waste

TOOLS & EQUIPMENT

• Are tools and equipment being used, Safe?<br>Consider their condition , right tool for the job and are they used correctly

  SAFE

  AT RISK

  N/A

• Tools & Equipment are:

  Select Not right for the job Not being used correctly Not in a safe condition

  • Not right for the job
  • Not being used correctly
  • Not in a safe condition

PPE

• Check Eyes & Face, Ears, Respiratory, Hands, Arms, Feet & Legs, Trunk, etc

  SAFE

  AT RISK

  N/A

• Select Reason

  Select Eye protection Safety boots / shoes Noise protection Safety vest / clothing Not fit for purpose In poor Condition Other

  • Eye protection
  • Safety boots / shoes
  • Noise protection
  • Safety vest / clothing
  • Not fit for purpose
  • In poor Condition
  • Other

• Enter details

PARTICULAR SITE HAZARDS OR CURRENT TOOLBOX TOPICS TO LOOK OUT FOR - LIST BELOW

• Are there any risks present for the listed hazards ?

  SAFE

  AT RISK

  N/A

• List the risks ?

OUTCOMES

• Safe acts observed

• Unsafe acts observed

SAFETY CONVERSATIONS

• IS A SAFETY CONVERSATION REQUIRED?<br>Ask if the worker has carried out a Stop and Think check today?

  YES

  NO

  N/A

• 1. Check that it is safe to have a conversation
  2. Start with a Positive Comment.
  3. Discuss
  Consequences of the unsafe act (if observed)
  Safer ways to do the task / process
  4. Gain agreement on improvements
  5. Discuss any other safety issues
  6. Thank the employee.

• How do you feel it went?

• DISCUSS BETWEEN THE OBSERVERS HOW THE SAFETY CONVERSATION/ DISCUSSION COULD BE IMPROVED?

Record Actions

• List corrective action required

• List any hazards or near miss incidents to be entered in Sustainavault

• Enter any hazards or near misses into Sustainavault

  YES

  NO

  N/A

• 
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OBSERVERS SIGNATURE

• Observer 1

  Sign

• Observer 2

  Sign