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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.

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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
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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.