Bbs - critical behavior index checklist
Behavioral based safety - critical behavior index
What does this form include?
This form contains 17 sections:
Office Ergonomics
- Upper back and neck
- Lower back
- Shoulders and Elbows
- Typing / Mousing
- Recognizing discomfort
- Breaking up static posture
PPE
- Eye / Face / Head / Hearing Protection
- Hand Protection
- Fall Protection
- Clothing / Foot Protection
- Respiratory Protection
Body Use and Position
- Body Square to Task
- Break-up / Rotate Repetitive Tasks
- Focus on Task (hand / eye placement)
- Pushing / Pulling Objects
- Breaking Up Static Posture
- Prolonged Standing (One Foot Forward)
Lifting
- Knees Bent / Back Straight
Work Environment
- Slip / Trip / Fall Hazard
- Housekeeping / Material Storage
- Barricades / Work Area Secured
- Spill Prevention
- Chemical / Flammable Hazards addressed
Tools & Equipment
- Correct Tool Selection
- Tool Use & Condition
- Safety Guards in Place
- Use of Lifting Equipment
Forklift / Manlift
- Safety Belt / Harness in Place
- Load Balanced / Stacks / Fork Position
- Cones and Barricades in Place
Light Vehicle / Truck
- Visual Pre-inspection Performed: signals, lights, horn
- Seat Belts / Both Hands on Wheel
- Looking 15 seconds Ahead
- Following / Stopping Distances
- Mirrors / Blind Spots
- Eyes Moving Frequently / Relevant Objects
- Space Cushion / Have an "Out"
- Eye Contact / Proper Use of Signals / Horn
A1 - Disagrees with safe practice
A1 - disagrees with safe practice
- Thinks this way is safe
- Disagrees with the observer on safe practice for the job
A2 - Personal Choice / Shortcuts
A3 - Job Knowledge
A4 - Job Focus
A5 - Facilities / Equipment
A6 - Management System
Name and signature of observer
Date and time of completion Date
Use this template