Behavior-based Safety Checklist Template

About the Behavior-based Safety Checklist Template

A behaviour based checklist template can systematize the inspections for the smooth operation of each workplace and the protection of employees. Utilizing digital behaviour based safety program templates can help organizations eliminate root causes of at-risk behaviour and inspire employees to be self-accountable. Behaviour-based safety (BBS) can ensure that safety programs are being implemented in the workplace

Review in depth your workplace with a behavior based checklist template

A BBS program's principal goal is to spotlight harmful behavioural standards while simultaneously providing constructive reinforcement for safe ones. A behavioural safety audit checklist can show how employees practice safe behaviours in the workplace.

By conducting inspections using work safety checklists, you can observe various tasks, provide timely feedback and analyze the root causes of unsafe acts. Properly carrying out behaviour-based safety program templates can uncover systemic issues, reduce job-related injuries, and improve workplace morale.

You can easily download our workplace inspection checklist pdf, but our digital version is a more effective approach to directly encourage employees to consider every factor that might be harmful to their safety. Our App provides QR choices for speedy group communication, plenty of features, and simple navigation.

In our related checklist article, you can find important information on how the implementation of such a system can bring significant benefits to your workplace. It includes the most recent practices that can change behaviour, not as a means of selective punishment, but as an identification of deficiencies, and understanding of the reasons for change.

Using Lumiform’s workplace safety checklist template, you can carry out an in-depth review and better understand the conditions under which your employees are working. In our behaviour-based checklist template, you have the possibility to define for yourself which are the safe conditions and which parts of the company should be improved. The end product is an important factor in the development of an organization, but the safety of those who work for it is even more important.

Categories

Workplace safety templates

Preview of the template

Audit

At-Risk BARRIERs

1. Training Issue, Unfamiliar - never trained, unqualified, too long since training, unusual task. 2. Management Pressure / System - time constraints, hurry, priority, poor job coordination. 3. Apathy, Insignificant - don't care, unimportant. 4. Facility and Equipment Condition - design, modification or deterioration contributing to at-risk condition or behavior. 5. Disagreement on At-Risk Practices - cannot agree that an at-risk condition or behavior exists. 6. Personal Factors or Distractions - not thinking, mind not on the task at hand, preoccupied, self imposed pressure. 7. Accepted Culture or Peer Pressure - doing the wrong thing because our peers do, going along with the crowd, rather not “rock the boat”. 8. Environment Related - affected by weather, insects, wildlife.

Critical Behavior Elements

1.0 PPE

1.1 • Eye & Face Protection - wearing proper eye and face protection for the task (glasses, face shield, goggles).

At-Risk BARRIER

1.2 • Hand Protection - proper gloves (high voltage gloves, rubber gloves, gallant style).

At-Risk BARRIER

1.3 • Body Protection - proper protective clothing (acid suit, steam suit, rubber apron) including seat belts.

At-Risk BARRIER

1.4 • Foot Protection - proper foot protection (safety shoes, boots).

At-Risk BARRIER

1.5 • Fall Protection - properly protected from falling when working where this hazard exits (safety harness, body harness, tie-offs).

At-Risk BARRIER

1.6 • Hearing Protection - wearing proper hearing protection where the hazard exists (ear plugs, ear muffs).

At-Risk BARRIER

1.7 • Head Protection - hard hat worn appropriately where hazard exists.

At-Risk BARRIER

2.0 BODY USE and POSITION

2.1 • Line of Fire - worker is positioning his body to avoid injury by any moving hazards (reflected arcs, escaping steam, falling objects).

At-Risk BARRIER

2.2 • Lifting - proper lifting techniques (using legs, back straight, weight close to body, feet flat on floor, knees bent).

At-Risk BARRIER

2.3 • Pinch Point - aware of and avoid pinch points (pinch points blocked, maintaining body parts out of pinch points).

At-Risk BARRIER

2.4 • Awkward Position - proper body mechanics (over-extended, using legs not back when pulling).

At-Risk BARRIER

3.0 TOOLS and EQUIPMENT

3.1 • Tool Use / Selection - using the right tool for the job and using it properly (correct style wrench, opening only one drawer at time).

At-Risk BARRIER

3.2 • Condition - tools, even if correct for the job, must be in good condition (electrical cords properly insulated).

At-Risk BARRIER

3.3 • Position Parked - vehicle is left in the position which creates the least possibility of incident (back before parking).

At-Risk BARRIER

3.4 • Ergonomics (Design) - system / component designed to be user friendly, with the operator(s) in mind (accessible, low strain).

At-Risk BARRIER

4.0 EYES ON PATH / HANDS

4.1 • Eyes On Path - watching what you're doing and where you're going (looking for / being aware of hazards).

At-Risk BARRIER

4.2 • Eyes On Hands - aware of hand placement (watching where hands are placed during work or near hazard, not being distracted).

At-Risk BARRIER

4.3 • Ascending / Descending - proper climbing techniques on ladders/stairs, both portable and stationary (facing ladder, not skipping rungs or steps, hold onto railing).

At-Risk BARRIER

4.4 • Travel Path - non-hazardous route of travel, path of least potential incident (walking / driving around spills, barricades, rough terrain).

At-Risk BARRIER

4.5 • Travel Speed - rate of speed to minimize potential incidents based on environment, surroundings or changing conditions.

At-Risk BARRIER

5.0 PROCESS HAZARDS

5.1 • Lockouts / Tagouts - are workers protected from potential hazards (locks / tags / grounds applied or removed, lines depressurized).

At-Risk BARRIER

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This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.