Personal Protective Equipment All safe Behavior All Safe Behavior Crew understands job plan Safety Glasses / Face Shield JSA presented to observer Hard hat Hazards recognized and communicated Saw Chaps / gloves among crew Clearly understood hand signals, eye Fire Resistant Clothing contact, Changes in plans or conditions communicated Human Factors Housekeeping All Safe Behavior All Safe Behavior Hurried / Rushed Slips / Trips / Falls hazards Complacency Tools & Materials organized Frustrated Vehicle / Equipment organized Fatigued Environmental standards adhered Work Positioning Fire hazard, welding, grinding, burning All Safe Behavior Tools & Equipment Struck by, Line of Fire Working off balance or award All safe Behavior positioning Right tool for the job Mobile equipment use Tool used in safe manner Temporary Traffic Control Condition of tools and safety items Tool guards in-place / used Lifting, over-reaching, twisting, bending Observations Risk” Observation Discussion / Corrective action(s) Observation Discussion “At “Safe” Client: Date: Division: General Superintendent / General Manager: Superintendent / General Foreman Foreman / Crew Observer:
Personal Protective Equipment All Safe Behavior All safe Behavior Safety Glasses / Face Shield Crew understands job plan Hard hat JSA presented to observer Saw Chaps / gloves Hazards recognized and communicated among crew Fire Resistant Clothing Clearly understood hand signals, eye contact, Human Factors Changes in plans or conditions communicated All Safe Behavior Housekeeping Hurried / Rushed All Safe Behavior Complacency Slips / Trips / Falls hazards Frustrated Tools & Materials organized Fatigued Vehicle / Equipment organized Work Positioning Environmental standards adhered All Safe Behavior Fire hazard, welding, grinding, burning Struck by, Line of Fire Tools & Equipment Working off balance or award positioning All safe Behavior Mobile equipment use Right tool for the job Temporary Traffic Control Tool used in safe manner Lifting, over-reaching, twisting, bending Condition of tools and safety items Tool guards in-place / used Observations “At Risk” Observation Discussion / Corrective action(s) “Safe” Observation Discussion Client: Date: Division: General Superintendent / General Manager: Superintendent / General Foreman Foreman / Crew Observer:
Section-61-Behavior-Based-Safety-Program.docx