Behavior based safety observation checklist
Record bbso for records
What does this form include?
This form contains 19 sections:
Observers name
Employee observed
Date and time of observation Date
Select Department where observation occurred
Describe positive behaviors observed
Photos if helpful
Describe conversation with associate about positive behaviors
Describe each at risk behavior
Describe behavior observed
Photos showing risks
Describe preventative action discussed with employee
Photo showing preventative actions/behaviors
Observer name and signature
Observer 2 name and signature
Employee name and signature
Comments - Recommendations
Photos
Review Date
General Manager signature
Use this template