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Critical Behavior Checklist Template

The Critical Behavior Checklist Template helps identify, assess, and manage challenging behaviours. It provides a systematic way to track behaviours, pinpoint triggers, and establish strategies to help reduce challenging behaviours. It is an essential tool for behaviour management in any educational or healthcare setting.

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Office Ergonomics
Upper back and neck
Lower back
Shoulders and Elbows
Typing / Mousing
Recognizing discomfort
Breaking up static posture
Eye / Face / Head / Hearing Protection
Hand Protection
Fall Protection
Clothing / Foot Protection
Respiratory Protection
Body Use and Position
Body Square to Task
Break-up / Rotate Repetitive Tasks
Focus on Task (hand / eye placement)
Pushing / Pulling Objects
Breaking Up Static Posture
Prolonged Standing (One Foot Forward)
Knees Bent / Back Straight
Objects Close / Weight Test
"Build a Bridge"
Work Environment
Slip / Trip / Fall Hazard
Housekeeping / Material Storage
Barricades / Work Area Secured
Spill Prevention
Chemical / Flammable Hazards addressed
Tools & Equipment
Correct Tool Selection
Tool Use & Condition
Safety Guards in Place
Use of Lifting Equipment
Forklift / Manlift
Safety Belt / Harness in Place
Load Balanced / Stacks / Fork Position
Cones and Barricades in Place
Light Vehicle / Truck
Visual Pre-inspection Performed: signals, lights, horn
Seat Belts / Both Hands on Wheel
Looking 15 seconds Ahead
Following / Stopping Distances
Mirrors / Blind Spots
Eyes Moving Frequently / Relevant Objects
Space Cushion / Have an "Out"
Eye Contact / Proper Use of Signals / Horn
Reasons for At-Risk Behavior
A1 - disagrees with safe practice
A1 - Disagrees with safe practice
Thinks this way is safe
Disagrees with the observer on safe practice for the job
A2 - Personal Choice / Shortcuts
Aware of hazard but too rushed / extra work
Chooses to work at risk for medical reasons
Chooses to not spend money for PPE
Peers all do the job this wayA3
A3 - Job Knowledge
Unaware of safe practices for specific job
Unaware of risks associated with work location
Doesn't think a specific safe practice applies to the job
A4 - Job Focus
Lost focus, thinking about anything other than current task
A5 - Facilities / Equipment
Different Design of facilities or equipment needed
Proper tools or safety equipment not available
A6 - Management System
Leader supports doing the job this way
Leader disagrees with safe practice
Name and signature of observer
Date and time of completion
Share this template:
The Critical Behavior Checklist Template is a helpful tool for managing and monitoring employee behaviour in the workplace. It provides a comprehensive list of critical behaviours that are essential for successful performance. This template can be used to identify and assess employee strengths and weaknesses, determine training and development needs, measure progress, and make decisions regarding rewards and recognition. It also allows employers to document and track improvements in employee behaviour over time. This template is an invaluable tool for any business looking to ensure their employees are performing to the best of their abilities.
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.