undefined
HomeAll templateschecklistsbehavior based safety observation form

Behavior based safety observation form

A new safety checklist designed with safety in mind is the behaviour based safety observation form checklist. The checklist is intended for anyone who is in charge of observing workers for safety precautions while they are at work. It is an important form that should be used on a weekly basis to ensure that your employees have the necessary tools and precautions while working in their specific department (s).

Time to complete

2 minutes

Eligibility

Anyone can fill out a behavior-based safety observation form.

undefined

Questions for Behavior based safety observation form

1.

Personal Protective Equipment (PPE) 

The answer should be a single (or) multiple choice by row and column:
Hand protection
Fall protection
Eye & face
Respirator, dust mask
Hearing protection
Correct & complete PPE
Safe
Risk
NA
2.

Proper use of PPE

The answer should be a single choice:
  1. Yes
  2. No
3.

PPE in good condition

The answer should be a single choice:
  1. Yes
  2. No
4.

Tools & Equipment

The answer should be a single (or) multiple choice by row and column:
Tools used properly & in good condition
Tools, equipment, supplies in designated area
Tools & equipment – correct selection, use
Mobile equipment
Guards, barriers & warnings
Correct & complete PPE
Motorized equipment
Yes
No
5.

Procedures available & up-to-date

The answer should be a single choice:
  1. Yes
  2. No
6.

Workers aware of procedure

The answer should be a single choice:
  1. Yes
  2. No
7.

Workers aware of procedure

The answer should be a single choice:
  1. Yes
  2. No
8.

Correct fall arrest equipment

The answer should be a single choice:
  1. Very poor
  2. Poor
  3. Fair
  4. Good
  5. Excellent
9.

Correct use of fall arrest equipment

The answer should be a single choice:
  1. Very poor
  2. Poor
  3. Fair
  4. Good
  5. Excellent
10.

Use of correct ladder, lift or scaffolding

The answer should be a single choice:
  1. Very poor
  2. Poor
  3. Fair
  4. Good
  5. Excellent
11.

Correct fall protection barriers at required place

The answer should be a single choice:
  1. Yes
  2. No

Similar Ideas

  • Behavior-based safety checklist
  • Behavior-based safety analysis form
  • Behavior-based safety self-assessment form

Here are some FAQs and additional information
on Behavior based safety observation form

What are behavior-based safety observations?

Behavior-based safety observations are those which keep in mind the safety of the workers and are efforts made consciously to reduce the risk caused to the workers.

What is behavior-based safety?

Behavior-based safety is a process in a workplace that informs both the workers and the management about the overall safety and the risks involved. And it is focused entirely on the safety of their daily safety behavior.

How do you conduct a behavior-based safety observation?

You can conduct a behavior-based safety observation by conducting behavior observations, checklists, and surveys. We also recommend you check out the premade template available at BlockSurvey as we bet that it will save a big chunk of your time.

Where can I find the behavior-based safety observation form?

You can access the behavior-based safety observation form available at BlockSurvey within just a few taps.

Why is behavior-based safety important?

When performed at regular intervals, behavior-based safety observations can reduce the hazards and risk factors and increase the safe behavior of the workers to a large extent.

Want to use this template?

Loved by people at home
and at work

undefined
“BlockSurvey is a simple, effective, and scalable tool for creating surveys for leadership and learning assessment. It's one of this year's best buying choices. Each month, it keeps improving and strives to serve its customers needs.”
Nelson Emilio
Personal Branding Strategist
undefined
“I use BlockSurvey to get feedback about all my activities and events. It is really easy to get started and create my first surveys! Then I could see how easy it was to share them. Now I am thinking to use BlockSurvey also within my creative process as an author in order to listen and engage with my audience, knowing that anonymity provides the most sincere and reliable answers.”
Georgina García-Mauriño
Author & Designer
BlockSurvey social proof
G2 Crowd
4.8 Star Rating
BlockSurvey social proof
Dapp.com
Editor's choice
BlockSurvey social proof
Capterra
4.9 Star Rating

What's next? Try out templates like
Behavior based safety observation form

1000+ Templates, 50+ Categories

Explore more
undefined
Behavior based safety observation form
A new safety checklist designed with safety in mind is the behaviour based safety observation form checklist. The checklist is intended for anyone who is in charge of observing workers for safety precautions while they are at work. It is an important form that should be used on a weekly basis to ensure that your employees have the necessary tools and precautions while working in their specific department (s).

Want to create secure online forms and surveys?

Join BlockSurvey.

SHARE