Observations-Field

Observation-Field

Observer Name (not required)

Invalid Input

District

Invalid Input

Date

Invalid Input

Observed-Dept. or Org

Invalid Input

Task/Job Observed

Invalid Input

Location of Observation

Invalid Input

Please skip the item or section if it is not applicable to the task/job that is included in the observation. A skipped question is considered NA.

Tools & Equipment

Correct Tool/Equipment

SafeAt-Risk Invalid Input

Used Correctly

SafeAt-Risk Invalid Input

Condition of Tool/Equipment

SafeAt-Risk Invalid Input

Comments

Invalid Input

Housekeeping

Slip/Trip/Fall Hazards

SafeAt-Risk Invalid Input

Clear Floor/Exits

SafeAt-Risk Invalid Input

Lighting

SafeAt-Risk Invalid Input

Comments

Invalid Input

Noted Safe Behaviors

Invalid Input

Reasons Behind At-Risk Behaviors

Invalid Input

Solutions Proposed/Implemented

Invalid Input

Attach a photo or video. (not required)

Invalid Input

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