TOWELL ENGINEERING SERVICES CO LLC

EMPLOYEE SAFETY EVALUATION REPORT

Employee Name: Date:
Employee ID:
Designation:
Department:
Award for the Month:

Total
Sl No Evaluation Details Fair Satisfactory Good Excellent Score
Scores

1 Job Knowledge

a Understand duties & responsibilities

b Level of proficient

2 Work Quality

a Accuracy

b Dependability of result

3 Attendance

a Reporting to work

4 HSE compliances
Personal Protective Equipments
a
Compliance of HSE procedure

b Reporting - Near Miss

c Attending TBT meeting & HSE training

d Behaviour (Disipline & attitude)

e Emergency awareness

5 Score Guidelines
a Fair : 4
b Satisfactory: 6
c Good: 8
d Excellent: 10

Remarks/ Comments:

Prepared By: Designation: Sign:

Reviewd By: Designation: Safety Engineer/Officer Sign:

Approved By: Designation: HSE Manager Sign: