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Safety performance evaluation template

Safety performance evaluation template

Track what’s really happening on the ground with an evaluation template that covers critical areas like training, reporting, and risk control.

Use this template
or download pdf
Safety performance evaluation template

Track what’s really happening on the ground with an evaluation template that covers critical areas like training, reporting, and risk control.

Use this template
or download pdf

About the Safety performance evaluation template

Gain a clear picture of on-site risks and safety practices with this customizable safety performance evaluation template. It’s an easy-to-use tool for running consistent checks, documenting real conditions, and making safety performance measurable. With this template, you’ll be able to assess safety culture, training quality, hazard controls, and incident management. It works for both quick walk-throughs and deep dives alike, and you can use it right from your phone or tablet.

How to use the safety performance evaluation template

A safety performance evaluation looks at how how deeply safety is actually integrated into your day-to-day operations. This template gives you a structured, repeatable way to uncover what’s working (and what’s not) across your safety culture:

  1. Customize the checklist to reflect your environment. Before assigning or filling anything out, take a few minutes to edit the template based on your site or team needs. For example, if you’re in a warehouse, you might add items around forklift operation. The template is fully editable in the app, so tweak language, remove irrelevant rows, or add examples that speak your team’s language.
  2. Use the template during a live walk-through. Evaluate conditions and practices in real time, whether you’re in the back of a retail store or out on a construction site. Observe, ask questions, and complete each section honestly, with the goal of improvement.
  3. Add meaningful comments. A simple yes or no doesn’t tell the full story. You can add comments anywhere to flag concerns, note areas of excellence, or suggest follow-ups. These notes are invaluble when it comes time to plan improvements or communicate findings to leadership.
  4. Assign follow-ups immediately. If you uncover issues, don’t let them stay unresolved. Within the app, you can assign action items straight from the checklist. This helps keep the loop tight from identifying a problem to resolving it, without relying on memory or scattered emails.
  5. Track progress over time. Once you’ve used this a few times, trends will start to emerge. You’ll be able to spot recurring gaps, see if training is sticking, or confirm whether corrective actions are actually working. Use built-in analytics to pull reports and make your safety strategy data-driven.

Best practices for using a safety performance evaluation

Most companies have some form of safety monitoring in place, but inconsistent evaluations can still lead to issues not being noticed. You can apply these tips to maximize the template and conduct proactive safety management.

Start by setting a clear schedule for evaluations—weekly, monthly, or by shift, depending on your industry risk level. Sticking to a schedule makes it easier to spot trends early and avoid recency bias.

Avoid rushing through the form just to get it done. Instead, engage directly with the frontline team while evaluating. Prepare questions, look at actual behaviors, and note anything that doesn’t match official policy.

Leverage the comments feature to take note of recurring issues. By consistently documenting observations, such as repeated training gaps or overlooked areas, you’ll identify patterns faster and prioritize action items. This also allows you to implement targeted improvements with greater accuracy and accountability.

Standardize how you track performance with Lumiform’s tools

Start using this template to streamline how you evaluate safety practices across teams and locations. Assign it to supervisors or team leads, capture insights with flexible response options, and keep your documentation consistent, no matter who’s filling it out. This easy-to-use template gives you the structure to spot issues early and track improvements over time.

Related categories

  • Health and safety management templates
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  • Safety templates
  • Workplace safety templates
Preview of the template
entity_item!!!
Page 1
Safety Culture
Does the organization demonstrate a strong commitment to safety?
Are safety policies and procedures clearly communicated to all employees?
Do employees actively participate in safety-related activities?
Is there a positive safety-first attitude among the workforce?
Safety Training
Do all employees receive comprehensive safety training?
Is safety training regularly reviewed and updated?
Are training records well-maintained and accessible?
Do employees demonstrate a good understanding of safety protocols?
Incident Management
Are all incidents and near-misses promptly reported?
Are incident investigations thorough and effective?
Are corrective actions implemented in a timely manner?
Is there a system in place to share lessons learned?
Hazard Identification and Control
Are hazards regularly identified and assessed?
Are effective controls implemented to mitigate risks?
Are employees actively involved in hazard identification?
Are safety audits and inspections conducted regularly?
Performance Monitoring
Are relevant safety performance metrics tracked and analyzed?
Are safety performance targets and objectives set and reviewed?
Are safety improvement plans and initiatives implemented effectively?
Is safety performance communicated to all stakeholders?

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Related resources

Access a complete set of resources aimed at maximizing safety, quality, and operational excellence, including detailed guides, related templates, and real-world use cases.

Topic guides

Read in-depth guides covering key topics related to this article.

Hazard communication program: A guide for workplace safetyWorkplace safety: Best strategies and practicesChemical hazards: A mandatory risk assesment guide (with examples for businesses & industries)
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Template collections

See comprehensive collections of best practice templates related to this topic.

5 free safety performance templates for tracking KPIs5 hazard identification forms for workplace safetyTop 4 free OSHA 301 form templates for workplace safety
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Use cases

Check out how the Lumiform software can be utilized for related use cases.

Health and safety management system softwareWorkplace safety softwareIncident report softwareJob safety analysis software
See all use cases

Other resources

Explore all the additional resources we offer to assist you in mastering this topic.

10 reasons why workplace safety is important4 ways that workplace safety increases worker productivityHow to write a workplace safety policyThe importance of personal protective equipment (PPE) in workplace safety

Frequently asked questions

What should you look for during a safety performance evaluation?

Pay attention to what’s missing or unclear. Gaps in training records, inconsistent use of PPE, or outdated hazard signage are red flags. Also, talk to employees. Their input can reveal risks or patterns that formal inspections might miss. The goal is to get an accurate assessment rather than simply a policy review.

How do you avoid bias when evaluating safety performance?

Always go in with a clear set of criteria and stick to it. Use a checklist or framework that asks specific questions. Bring someone with you if possible, and don’t rely only on visual checks. Include incident data, worker feedback, and maintenance records to round out your view.

How can you make evaluation results useful for the whole team?

Summarize key findings in simple language and share them with everyone, not just management. People are more likely to act on feedback if they understand it. Use team meetings or visual boards to share trends or updates. If workers see their input reflected in changes, engagement becomes higher.


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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