Template

Job Safety Plan (JSP) Template

by Kevin Bernier, from the Community

10+

Use this Job Safety Plan (JSP) template to break work into job steps, record observations, and assess risks for each task. Identify hazards including electrical, fall, excavation, mechanical, chemical, noise, visibility, extreme temperature, and weather. Specify engineering and administrative controls and required PPE, reference permits and life-saving rules, and add explanations and recommendations. Capture supervisors and workers covered by the JSA, document incidents or near misses, and confirm all personnel understand and agree with the plan.

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With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
JSA Template Free Job Safety Analysis Form
This JSA template helps teams break jobs into steps, spot hazards, and record effective control measures. Capture details for each job step, assess risks such as chemical, electrical, ergonomic, excavation, fall, fire, mechanical, noise, radiation, struck by objects, temperature, visibility, and weather. Document engineering and administrative controls, required personal protective equipment, and other preventive measures with clear explanations. Include photos, recommendations from the health and safety committee, and digital signatures to complete and verify the analysis. Use this form to standardize Job Safety Analysis, improve hazard awareness, and reduce incidents across worksites.
by Marleene Cerda, from the Community
Downloads: 0
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Template
Weeks Marine Inc Job Safety Analysis (JSA)
Use this Job Safety Analysis template developed for Weeks Marine Inc to plan safer marine construction tasks. Break work into job steps, identify hazards such as chemical, electrical, ergonomic, fall, fire, mechanical, noise, struck-by, extreme temperature, visibility, weather, and more. Select required PPE including hard hat, work vest, cut-resistant gloves, safety glasses, safety boots, hearing protection, and respirator with fit-test confirmation. Specify tools like chain fall, come along, cutting torch, ladder, extension cord, hand tools, and portable lighting with pre-use inspections and hot work permits where required. Rate risk levels, define engineering and administrative controls, assign PPE, and capture names and signatures.
by Ronnie Clifford, from the Community
Downloads: 10+
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Template
Job Safety Analysis Worksheet Template
This Job Safety Analysis worksheet helps teams break down tasks, identify hazards, and plan effective controls to reduce risk. Sections include task and site details, step-by-step job sequencing, hazard identification (struck-by, caught-between, electrical, chemical, ergonomic, noise, vibration, slips, trips, falls), and control measures across engineering and administrative controls, PPE, and substitution. It prompts for lockout tagout, machine guarding, lifting aids, signage, barriers, ventilation, and other mitigations. The form also captures required PPE, additional recommendations, and approvals with signatures for supervisors, EHS managers, and workers. Use it to standardize JSA practices and improve safety compliance across jobs and sites.
by Peter Stewart, from the Community
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Template
Daily Huddle and JSA Checklist
This Daily Huddle and Job Safety Analysis template helps construction teams plan the day’s work, identify hazards, and agree on controls before starting. Record crew attendance, jobsite conditions, start time, and weather. Review PPE requirements and assess risks such as utilities, excavation, traffic, tools, ergonomics, noise, and environmental factors. Document mitigation steps, equipment and tool inspections, barricades and crossings, and any near-miss notes. Attach photos, complete post-job review, and collect signatures.
by Rebecca tippie, from the Community
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Job Safety Plan (JSP) Template

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JSA Template Free Job Safety Analysis Form

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