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  • BBS - Critical Behavior Index - SafetyCulture

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    This document appears to be a checklist for conducting a workplace safety audit. It contains several sections evaluating different aspects of workplace ergonomics, PPE use, body positioning, lifting safety, work environment hazards, tool use, forklift safety, and vehicle operation. For each item, the auditor selects whether the observed behavior or practice was safe, at risk, or not applicable. At the end, there is a section for providing reasons why any at-risk behaviors were observed, including options like disagreeing with safe practices, taking shortcuts, lack of knowledge, lost focus, lack of proper equipment or supportive management systems.

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    This document appears to be a checklist for conducting a workplace safety audit. It contains several sections evaluating different aspects of workplace ergonomics, PPE use, body positioning, lifting safety, work environment hazards, tool use, forklift safety, and vehicle operation. For each item, the auditor selects whether the observed behavior or practice was safe, at risk, or not applicable. At the end, there is a section for providing reasons why any at-risk behaviors were observed, including options like disagreeing with safe practices, taking shortcuts, lack of knowledge, lost focus, lack of proper equipment or supportive management systems.

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    3 views9 pages

    BBS - Critical Behavior Index - SafetyCulture

    Uploaded by

    constantinop.gonzalez
    This document appears to be a checklist for conducting a workplace safety audit. It contains several sections evaluating different aspects of workplace ergonomics, PPE use, body positioning, lifting safety, work environment hazards, tool use, forklift safety, and vehicle operation. For each item, the auditor selects whether the observed behavior or practice was safe, at risk, or not applicable. At the end, there is a section for providing reasons why any at-risk behaviors were observed, including options like disagreeing with safe practices, taking shortcuts, lack of knowledge, lost focus, lack of proper equipment or supportive management systems.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 9

    5/3/24, 10:40 BBS - Critical Behavior Index - SafetyCulture

    Go digital today!
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    Information

    Document No.

    Audit Title

    Client / Site

    Conducted on 

    Prepared by

    Location 

    Personnel

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    5/3/24, 10:40 BBS - Critical Behavior Index - SafetyCulture

    Office Ergonomics

    Upper back and neck

    Safe At Risk N/A

    Lower back

    Safe At Risk N/A

    Shoulders and Elbows

    Safe At Risk N/A

    Typing / Mousing

    Safe At Risk N/A

    Recognizing discomfort

    Safe At Risk N/A

    Breaking up static posture

    Safe At Risk N/A

    PPE

    Eye / Face / Head / Hearing Protection

    Safe At Risk N/A

    Hand Protection

    Safe At Risk N/A

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    5/3/24, 10:40 BBS - Critical Behavior Index - SafetyCulture

    Fall Protection

    Safe At Risk N/A

    Clothing / Foot Protection

    Safe At Risk N/A

    Respiratory Protection

    Safe At Risk N/A

    Body Use and Position

    Body Square to Task

    Safe At Risk N/A

    Break-up / Rotate Repetitive Tasks

    Safe At Risk N/A

    Focus on Task (hand / eye placement)

    Safe At Risk N/A

    Pushing / Pulling Objects

    Safe At Risk N/A

    Breaking Up Static Posture

    Safe At Risk N/A

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    5/3/24, 10:40 BBS - Critical Behavior Index - SafetyCulture

    Prolonged Standing (One Foot Forward)

    Safe At Risk N/A

    Lifting

    Knees Bent / Back Straight

    Safe At Risk N/A

    Objects Close / Weight Test

    Yes No N/A

    "Build a Bridge"

    Safe At Risk N/A

    Work Environment

    Slip / Trip / Fall Hazard

    Safe At Risk N/A

    Housekeeping / Material Storage

    Safe At Risk N/A

    Barricades / Work Area Secured

    Safe At Risk N/A

    Spill Prevention

    Safe At Risk N/A

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    5/3/24, 10:40 BBS - Critical Behavior Index - SafetyCulture

    Chemical / Flammable Hazards addressed

    Safe At Risk N/A

    Tools & Equipment

    Correct Tool Selection

    Safe At Risk N/A

    Tool Use & Condition

    Safe At Risk N/A

    Safety Guards in Place

    Safe At Risk N/A

    Use of Lifting Equipment

    Safe At Risk N/A

    Forklift / Manlift

    Safety Belt / Harness in Place

    Safe At Risk N/A

    Load Balanced / Stacks / Fork Position

    Safe At Risk N/A

    Cones and Barricades in Place

    Safe At Risk N/A

    https://public-library.safetyculture.io/products/bbs-critical-behavior-index?amp_dev=aa3cb5a6-b7e1-4fe0-a70a-63e3a3695033&sid=1709498350… 5/9
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    Light Vehicle / Truck

    Visual Pre-inspection Performed: signals, lights, horn

    Safe At Risk N/A

    Seat Belts / Both Hands on Wheel

    Safe At Risk N/A

    Looking 15 seconds Ahead

    Safe At Risk N/A

    Following / Stopping Distances

    Safe At Risk N/A

    Mirrors / Blind Spots

    Safe At Risk N/A

    Eyes Moving Frequently / Relevant Objects

    Safe At Risk N/A

    Space Cushion / Have an "Out"

    Safe At Risk N/A

    Eye Contact / Proper Use of Signals / Horn

    Safe At Risk N/A

    Reasons for At-Risk Behavior

    https://public-library.safetyculture.io/products/bbs-critical-behavior-index?amp_dev=aa3cb5a6-b7e1-4fe0-a70a-63e3a3695033&sid=1709498350… 6/9
    5/3/24, 10:40 BBS - Critical Behavior Index - SafetyCulture

    A1 - disagrees with safe practice

    A1 - Disagrees with safe practice

    Thinks this way is safe

    Disagrees with the observer on safe practice for the job

    A2 - Personal Choice / Shortcuts

    Aware of hazard but too rushed / extra work

    Chooses to work at risk for medical reasons

    Chooses to not spend money for PPE

    Peers all do the job this wayA3

    A3 - Job Knowledge

    Unaware of safe practices for specific job

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    5/3/24, 10:40 BBS - Critical Behavior Index - SafetyCulture

    Unaware of risks associated with work location

    Doesn't think a specific safe practice applies to the job

    A4 - Job Focus

    Lost focus, thinking about anything other than current task

    A5 - Facilities / Equipment

    Different Design of facilities or equipment needed

    Proper tools or safety equipment not available

    A6 - Management System

    Leader supports doing the job this way

    Leader disagrees with safe practice

    Name and signature of observer 

    https://public-library.safetyculture.io/products/bbs-critical-behavior-index?amp_dev=aa3cb5a6-b7e1-4fe0-a70a-63e3a3695033&sid=1709498350… 8/9
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    Date and time of completion 

    The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's
    solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice.
    You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should
    independently determine whether the template is suitable for your circumstances.

    https://public-library.safetyculture.io/products/bbs-critical-behavior-index?amp_dev=aa3cb5a6-b7e1-4fe0-a70a-63e3a3695033&sid=1709498350… 9/9

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