Doc No: FM0349

Valid from: 26/03/2011

Teekay Safety Observation Process (TSOP) Form Version: 15

Date (dd/mm/yyyy): 28/04/2015 Department: Catering Vessel: Hispania Spirit

Time started (HH:mm): 11:00 Time ended (HH:mm): 11:15 Observation Location: Accomodation

Rank of Observer No. 1 Chief Officer Rank of Observer No. 2 Messman

OBSERVATION GROUPS & CATEGORIES

C = Reactions or D=
A = Operation of Tools/Equipment B = Procedures E = PPE & Positioning
Changes of People Housekeeping
Good
Followed Change In Body
1. Used Correctly 1. 1. 1. Housekeeping 1. Used Correctly
Correctly Position
Change In Use of
2. Not Used Correctly 2. Not Followed 2. 2. Poor Storage 2. Not Used Correctly
PPE
Not Poor
3. Not Right For Job 3. 3. No Reaction 3. 3. Not Used
Established Labeling
Change In Work
Inadequate Disorderly
4. In Poor Condition 4. 4. Tempo (slower or 4. 4. PPE in Poor Condition
Procedure Workplace
faster pace)
No or poor
Struck by – Hazard
5. Hazardous Location for equipment used 5. Knowledge 5. Fire Hazards 5.
(Standing in Line of Fire)
of Procedure
Risk
Assessment Blocked
6. Congested or Confined Area 6. Done 6. Escape 6. Ergonomic - Hazard
(formal or Routes
informal)
Risk
Assessment
7. Poor Visibility (Line of sight) 7. not done 7. Poor Lighting 7. Slip, Trip, or Fall - Hazard
(formal or
informal)
Caught or Pinched Between
8. Inspection Performed 8.
-Hazard
Lifting, Lower, Push, Pull
9. Inspection Not Performed 9.
(Exertion)
Identify Group and Corresponding Category. List a description of the situation and recommendation for a resolution.
Unsafe Act

Condition
Safe Act
Unsafe

Group & Category

Description of Task, Observation and Action Taken

1 D4-Disorderly Workplace Linen Locker untidy.

10
Notes for Follow up:
Tidy it up.

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