Behavior based safety observation form checklist

Body, Arms, and Hands: protected from resins, adhesives, sealants, chemicals and composite dust

Safe At Risk N/A

Eyes: protected from flying debris, chemicals and radiant light. Safety glasses worn in mandatory areas?

Safe At Risk N/A

Hands: protected when handling sharp objects/tools, severely hot or cold items

Safe At Risk N/A

Head: protected from impact from above and at same height objects?

Safe At Risk N/A

Hearing: protection used in mandatory areas and during short exposures to high decibel noise?

Safe At Risk N/A

Respiratory: protected for vapors, dust, misc. debris. Clean shaven, mask stored in sealed container

Safe At Risk N/A

Body Posture: wrist, neck back in neutral position, elbows 90, close to body?

Safe At Risk N/A

Grip/force: not excessive when combined with high frequency?

Safe At Risk N/A

Lifting/Lowering: weights not above 50# at/above shoulder height. Lift is not awkward or repetitive?

Safe At Risk N/A

Pushing: versus pulling?

Safe At Risk N/A

Reach: not overextended for long periods of time or during lifting?

Safe At Risk N/A

Repetition: is not excessive not excessive when combined with high force and frequency?

Safe At Risk N/A

Vibration: long exposures reduced by PPE, tape or tool design?

Safe At Risk N/A

6S: clean as you go is evident

Safe At Risk N/A

Fixtures/Carts/Racks: breaks, wheels and gen. frame operational. Pinch point iD'd

Safe At Risk N/A

Razor Blades: stored when not used, cut resistant gloves worn

Safe At Risk N/A

Tools/hoist: safety triggers operational, periodic checks done, no signs or wear or failure

Safe At Risk N/A

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