Behavioural safety observation checklist

Template Information

Visy hse 030-hse form 805

Category: manufacturing

Template Questions

  • What task / activity is being observed?
  • PHOTO IF REQUIRED
  • PERSONAL SAFETY
  • STANDARD WORKING PROCEDURES
  • SAFE WORK PRACTICE
  • HOUSEKEEPING
  • TOOLS & EQUIPMENT
  • PPE
  • PARTICULAR SITE HAZARDS OR CURRENT TOOLBOX TOPICS TO LOOK OUT FOR - LIST BELOW
  • Safe acts observed
  • Unsafe acts observed
  • SAFETY CONVERSATIONS
  • DISCUSS BETWEEN THE OBSERVERS HOW THE SAFETY CONVERSATION/ DISCUSSION COULD BE IMPROVED?
  • List corrective action required
  • List any hazards or near miss incidents to be entered in Vault
  • Record Actions
  • Observer 1
  • Observer 2