Lumiform / Templates / Behavior-Based Safety Observation Checklist

Behavior-Based Safety Observation Checklist

Use this behavior-based safety observation checklist as an example for what to look for in your own workplace. This checklist assesses employees’ ergonomics, PPE, tools and equipment, work areas, and procedures.

Downloaded 43 times

★ ★ ★ ★ ★

Rated 5/5 stars on Capterra

Say goodbye to paper checklists!

Lumiform enables you to conduct digital inspections via app easier than ever before

Cut inspection time by 50%
Uncover more issues and solve them 4x faster
Select from over 5,000 expert-proofed templates

Digitalize this paper form now

Cut inspection time by 50%
Uncover more issues and solve them 4x faster
Select from over 4000 expert-proofed templates

★ ★ ★ ★ ★

Rated 5/5 stars on Capterra

Behavior-Based Safety Observation Checklist

Behavior-based Safety Observation Checklist

Ergonomics

Safe

At Risk

Personal Protective Equipment

Safe

At Risk

Tools & Equipment

Safe

At Risk

Environment & Work Areas

Safe

At Risk

Procedures

Safe

Specify

At Risk

Specify

Sign Off

Additional Observations

Safety Manager's Name & Signature

This template is also available in:

Previous template

Next template

Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.