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Behavior Based Safety Observation Checklist Template

Behavior Based Safety Observation Checklist Template

Conduct your customized safety audits by using this behavior based safety observation checklist. Download now!

Use this template
or download pdf
Behavior Based Safety Observation Checklist Template

Conduct your customized safety audits by using this behavior based safety observation checklist. Download now!

Use this template
or download pdf

About the Behavior Based Safety Observation Checklist Template

A Behavior Based Safety Observation Checklist Template is a useful tool for assessing workplace safety. It outlines safe working practices and allows for the observation of employees’ behavior and adherence to safety protocols. The template can be customized to meet the specific needs of any workplace and is an essential part of a successful safety program.

A Behavior Based Safety Observation Checklist Template is a helpful tool to ensure a safe workplace. The template provides a comprehensive list of safety protocols and procedures to follow during operations. It encourages workers to observe their own and colleagues' behavior and identify risks before they become a problem. This template is customizable to fit the specific needs of any business and allows for tracking of observations. The template covers areas such as safety equipment, safety procedures, and awareness of safety risks, as well as allows for comments and feedback. This template is an effective tool to ensure safety in the workplace, reduce hazards, and increase employee awareness.

Related categories

  • Workplace safety templates
Preview of the template
Audit
Was daily safety check completed?
Housekeeping
Aisles/Walkways kept clear?
Work area kept organized?
Housekeeping: spills, cords or other trips, trash/clutter, lighting, or Flammables
Personal Protective Equipment
All appropriate equipment or gear worn correctly?
PPE kept in good condition?
Personal protective equipment: hand, body, eyes/face, head, foot, respiratory, fall protection, hearing protection, or FR clothing/gear
Working Position
Body position
Location in working environment
Working Position: poor posture, over stretched, above shoulder, below knees, twisting, caught in between, struck by, working at heights greater than 4', floor or wall opening, unprotected work edge, or false ceiling or floor.
Tools and Equipment
Appropriate tools or equipment being used?
Tools or equipment being used correctly?
Tools or equipment in good condition?
Tools and equipment: ladders, power or hand tools
Safe behaviors observed-actions taken to encourage safe behavior
Unsafe behaviors observed-action taken to correct and prevent recurrence
Line of fire. Is the worker in the line of fire?
Grinding or drilling operations creating flying objects or particles - goggles/face-shield. Heavy equipment movement in the area - operator aware of pedestrian? Around rigging operations - hand in pinch point not under equipment? Working in front of live electrical panel - NFPA70E PPE
Safety procedures
Lock-out/Tag-out, Arc Flash, Hot Work Permit, Confined Space
Add media
Auditor signature
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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.
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