Professional Documents
Culture Documents
Date Department
Work Area Section
Employee Being Observed
How often is Task performed Company Name
Machine/Equipment No being used Observers Name
Task being observed ID Number/ Coy No
Reason for observation Change Management Legal Compliance
New Worker Unplanned Task
New Task Ergonomic Factor
Known Risk Taker Incident Repeater
Poor Performer Good Performer
New/Unfamiliar Equipment Complicated Task
Is there good communication between the operator and his team members?
Does the operator using the tool have the correct PPE?
Does the operator using the tool use the PPE correctly?
Is the storage area of the tools sufficient and according to stacking and storage standards?
SOP
RA
2. PPE
DEVIATION CORRECTION/COACHING EMPLOYEE SIGNATURE
3. EQUIPMENT CONDITION
DIVIATION CORRECTION/COACHING EMPLOYEE SIGNATURE