• Document No.

  • Data

  • Sito / Cliente

  • Osservatore

  • Partecipante/i

  • Osservato

  • Attività di lavoro osservata

  • Azienda di appartenenza


  • Housekeeping

  • Workspace

  • Prevention and protection measures

  • Is hazards and requirements information available?


  • Push and pull

  • Lifting and lowering

  • Torsion

  • Crouch/snuggle

  • Overwork

  • Repetitive actions


  • Are the procedures known?

  • Are the procedures followed correctly?

  • Are food-safety standards satisfied?<br><br>(Use of food-contact approved materials; clean clothes and glowes; chance of product contamination; ...)

  • Are safety standards satisfied?

Working equipement

  • Is working equipement in good state?

  • Is working equipement correctly used?


  • Hands

  • Head

  • Eyes and face

  • Ears

  • Nose and mouth

  • Feet

  • Body

Personal evaluation

  • Is the worker aware of the risks due the activities he's doing and to' the place where those activities take place? Does he prevent them?

  • IMS qualification requirements are satisfied?

Recomanded actions

Signatures of participants

  • Worker observed

  • Person involved

  • Observer

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