Observations-Office

Observer Name (not required)

Invalid Input

District

Invalid Input

Date

Invalid Input

Observing Dept. or Org

Invalid Input

Observing Dept. or Org

Invalid Input

Observing Dept. or Org

Invalid Input

Observing Dept. or Org

Invalid Input

Observing Dept. or Org

Invalid Input

Observing Dept. or Org

Invalid Input

Observing Dept. or Org

Invalid Input

Observing 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.

Housekeeping

Slip/Trip/Fall Hazards

SafeAt-Risk Invalid Input

Storage/Clutter

SafeAt-Risk Invalid Input

Comments

Invalid Input

Body Position

Lifting/Bending

SafeAt-Risk Invalid Input

Reaching/Twisting

SafeAt-Risk Invalid Input

Paying Attention

SafeAt-Risk Invalid Input

Comments

Invalid Input

Layout/Work Environment

Monitor Position/Glare

SafeAt-Risk Invalid Input

Mouse & Pad/Keyboard

SafeAt-Risk Invalid Input

Adequate Lighting

SafeAt-Risk Invalid Input

Layout (frequently used tools nearby)

SafeAt-Risk Invalid Input

Comments

Invalid Input

Noted Safe Behaviors/Actions

Invalid Input

Reasons Behind At-Risk Behaviors

Invalid Input

Solutions Proposed/Implemented

Invalid Input

Attach a photo or video. (not required)

Invalid Input