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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.

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Behavior Based Safety Observation Checklist 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

(check name not set)

Unsafe behaviors observed-action taken to correct and prevent recurrence

(check name not set)

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
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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.

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