Worksite Safety Observation Checklist

• Mendi Constructions

• Task:

Site Observation Location:

Observation

• 1. Is the employee following established safety policies and procedures?

  Yes

  No

  N/A

• 2. Has the employee signed on to the appropriate WMS/JSEA? <br>If no explain.

  Yes

  No

  N/A

• 3. Is the employee maintaining proper housekeeping procedures in worksite?<br>If no aexplain

  Yes

  No

  N/A

• 4. Is the employee sutilising required PPE?

  Yes

  No

  N/A

• 6. Is the employee operating vehicles and / or equipment in a safe manner?

  Yes

  No

  N/A

• 5. Is the employee performing major job tasks ?

  Yes

  No

  N/A

• 6. Is the employee operating vehicles & / or equipment in a safe manner?

  Yes

  No

  N/A

• 7. Is machinery Pre-start completed? If no explain

  Yes

  No

  N/A

• 8. Is the employee wearing a seat belt? If no explain?

  Yes

  No

  N/A

• 9. Is employee's worksite considered hazardous?

  Yes

  No

  N/A

• 10. Has the employee completed competency assessment? If no explain

  Yes

  No

  N/A

• 11. What are the employee's potential hazards at this workplace?

  Yes

  No

  N/A

• Observers Signature:

  Sign

• Select date

  Date

• Employee Signature

  Sign

• Select date

  Date