Visible Felt Leadership

• Document No. LB_VFL_

• Site Name

• Conducted on

  Date

• VFL Conducted by:

At risk behavior evaluation

• PPE being used?

  Safe

  At Risk

  N/A

• PPE in good condition?

  Safe

  At Risk

  N/A

• Correct use of tools or equipment?

  Safe

  At Risk

  N/A

• Tools and equipment in good working order?

  Safe

  At Risk

  N/A

• Does the employee understand all his associated hazards and risks relating to his task?

  Yes

  No

  N/A

• Have the employee been trained in performing this activity/ task?

  Yes

  No

  N/A

• Supervision pro active in creating safe behavior with his employees?

  Yes

  No

  N/A

At risk conditions evaluation

• Housekeeping in work area?

  Safe

  At Risk

  N/A

• Edge protection?

  Safe

  At Risk

  N/A

• Scaffolding?

  Safe

  At Risk

  N/A

• Working at heights?

  Safe

  At Risk

  N/A

• Environmental?

  Safe

  At Risk

  N/A

Management Commitment

• Will an action plan be needed to rectify issues?

  Yes

  No

  N/A

• Summary

• Approved By:

  Sign