Safety Observation Form

Safety Observation Form

Use this form to document safety observations, including hazards or unsafe behaviors. Provide detailed descriptions, immediate actions, and recommendations. Ensure all relevant sections are completed and reviewed by a supervisor.

Date

    Location

      Observer's Name

        Observer's Job Title

          I. Description of the Issue

          Type of Observation

            • Hazard

            • Unsafe Behavior

            • Compliance Issue

            Detailed Description

            Provide a thorough description of what was observed, including any relevant conditions or context.

              II. Persons Involved

              Complete this section by listing all individuals involved, their positions, and contact information for follow-up and clarity.

              Name

              Job Title

              Contact Information

              III. Immediate Actions Taken

              Action Taken

              Describe any immediate corrective actions taken.

                Person Responsible

                  Date & Time of Action

                    IV. Recommendations

                    Short-Term Recommendations

                      Long-Term Recommendations

                        V. Follow-Up Actions

                        Action Required

                          Responsible Person

                            Deadline for Action

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