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
Pre use check carried out by whom? Name and signed off by relevant Supervisor
Is there good communication between the operator and his team members?
Is there a signed off and valid hot work permit available for the activities in the section?
What pre-causing measures are in place to prevent a fire and in case of a fire?
Is the electrical extension completely un routed and out of the walk ways?
Is the correct disk used for the task performed and still valid and safe?
Can the operator slip, trip or fall over anything whilst performing the task?
What PPE is the operator wearing whilst performing the task and is it to standard?
Does the operator ensure that his assistants (s) are complying with the PPE Requirements?
Does the operator allow the machine to come to a complete stop before putting it down?
When leaving the machine un attendant what does the operator do?
After completion of the task, are all steel shavings and cut offs removed from the area?
SOP
RA
2. PPE
DEVIATION CORRECTION/COACHING EMPLOYEE SIGNATURE
3. EQUIPMENT CONDITION
DIVIATION CORRECTION/COACHING EMPLOYEE SIGNATURE