Free Safety Performance Evaluation Template
Safety Performance Evaluation
[YOUR COMPANY NAME]
Date: [DATE]
This is an evaluation intended to measure and analyze the safety performance within the organization.
The Evaluation will focus on safety practices, adherence to regulations, incident reporting, risk management, and the overall safety culture.
Evaluation Criteria
The evaluation will utilize the following performance criteria:
1. Safety Practices- Proficiency in implementing and adhering to set safety procedures and protocols.
2. Compliance with Regulations- The level of adherence to local, state, and federal safety-related regulations.
3. Incident Reporting- The promptness, accuracy, and thoroughness of reporting incidents of safety breaches.
4. Risk Management- Competence in identifying potential safety hazards and taking appropriate measures to mitigate them.
5. Safety Culture- The overarching emphasis on safety within the organization, cultivated through attitudes, behaviors, and values.
Performance Ratings
-
1 (Poor) - Consistently fails to meet performance standards.
-
2 (Below Average) - Frequently fails to meet performance standards.
-
3 (Average) - Meets performance standards occasionally.
-
4 (Above Average) - Meets performance standards most of the time.
-
5 (Excellent) - Always meets and often exceeds performance standards.
Evaluation Table
|
Criteria |
Description |
Rating |
|---|---|---|
|
Safety Practices |
Implementation and adherence to set safety procedures |
|
|
Compliance with Regulations |
Adherence to local, state, and federal safety-related regulations |
|
|
Incident Reporting |
Promptness, accuracy, and thoroughness of incident reports |
|
|
Risk Management |
Identifying safety hazards and taking preventive actions. |
|
|
Safety Culture |
Emphasis on safety, through attitudes, behaviors, and values |
Additional Comments & Notes
|
Notes |
|
|---|---|
