Document: PTO –

Threading machine
PLANED TASK OBSERVATION Rev 2
Next Revision date:
SUPERVISORS / FOREMAN 29/7/16
Date Issued 20/7/15

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

1. Task Steps being observed

Does the Supervisor / Foreman have a valid medical and Inductions?

Is the Supervisor / Foreman appointed by the Responsible 2.6.1 appointee?

Is the Supervisor / Foreman competent? Does he/she have the necessary training?

Does the Supervisor give clear instructions to his team and unsure that all employees know what is expected of them?

Is there good communication between the Supervisor / Foreman and his team members?

Was the DSTI conducted with the team and did two-way communication take place?

Does the Supervisor / Foreman have copies of all the applicable Risk assessments / SHE Spec with him?

Does the Supervisor / Foreman make sure that his team members is wearing the correct PPE?

Does the Supervisor / Foreman take part in the Daily Toolbox Talks?

Does the Supervisor / Foreman ensure that Safe walkways and Safe Work platforms is available?

Does Supervisor / Foreman ensure that Housekeeping is maintained?

Does the Supervisor / Foreman take part in Reporting of events?

Does the Supervisor / Foreman help to create safety awareness?

5. Suggested Improvements (TO BE COMPLETED BY THE SUPERVISOR )

Page 1 of 2 Printed: 22 October 2022

 Document: PTO –
Threading machine
PLANED TASK OBSERVATION Rev 2
Next Revision date:
SUPERVISORS / FOREMAN 29/7/16
Date Issued 20/7/15

Revise SOP? Yes Use different PPE? Yes Engineering change Yes Re-Train Yes Placement of Yes
required? employee? employee?
No No No No No

Employee Task Observation

Employee Name: ______________________________________ I.D. No.: ______________

Job Title: _________

Date Assigned to Job: __

Operating Procedures Checked

Number Title Date Reviewed

SOP
RA

6. Feedback by observer to employee

1. TASK STEPS
DEVIATION CORRECTION/COACHING EMPLOYEE SIGNATURE

2. PPE
DEVIATION CORRECTION/COACHING EMPLOYEE SIGNATURE

3. EQUIPMENT CONDITION
DIVIATION CORRECTION/COACHING EMPLOYEE SIGNATURE

7. Acknowledgement and agreement on feedback received

Observation conducted by: Signature Date
Reviewed with Employee: Signature Date
Reviewed by Site Manager: Signature Date

Page 2 of 2 Printed: 22 October 2022