Template

LLS Safe Act Observation Checklist

by Keith Baker, from the Community

30+

Use this Safe Act Observation checklist to document safe behaviors and identify at-risk actions during field observations. Sections cover planning and permits, body posture and manual handling, vehicle and equipment operation, PPE condition and use, and isolation and tagging. Record additional behaviors, provide positive feedback, raise actions to address risks, and note items for the next toolbox meeting. Includes observer signature and guidance to escalate serious at-risk behavior.

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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

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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
Safe Act Observation Form
Use this Safe Act Observation (SAO) checklist to capture worker behaviors and site conditions. Sections cover planning and pre-start checks, SWP and SWMS review, hazard identification, permit requirements, MSDS or SDS awareness, correct tools and equipment, body posture and manual handling, driving and operating practices, PPE selection and condition, and isolation and tagging. Verify communication, responsible person, housekeeping, and general compliance. Record positive feedback, raise actions to address at-risk behaviors, and sign off observations.
by Stiza Te Moananui, from the Community
Downloads: 20+
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Template
Mining Safe Act Observation Checklist
Use this mining Safe Act Observation checklist to analyze and correct behaviors and site conditions. Sections cover risk assessment, permits, housekeeping, driving, tools and equipment, PPE, isolation and tagging, people positions, procedure compliance, and environment. Capture document details, site, time, observers, and record corrective actions and discussions with responsible personnel. Adapt this template to your operations and regulatory requirements.
by Hendrikus Engelbrecht, from the Community
Downloads: 30+
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Template
Behavior Observation Pink Card Form
Use this behavior based safety observation card to document safe and at risk actions during field work. The template includes sections for site, date, location, PPE checks for eyes, head, hands, hearing, breathing, feet, and body, as well as body positioning, line of fire, pinch points, lifting technique, ergonomics, attention and situational awareness. Capture work practices, communication, permits, tool and equipment use, housekeeping, and temperature considerations. Record observer notes, safe behaviors, at risk behaviors, and comments from the worker, then log corrective actions to drive continuous improvement.
by Kent Evatt, from the Community
Downloads: 20+
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Template
Safe Act Observation
Explore the Safe Act Observation template designed to ensure compliance, enhance efficiency and promote safety in your operations.
by SafetyCulture
Downloads: 200+
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Safe Act Observation Form

Use this Safe Act Observation (SAO) checklist to capture worker behaviors and site conditions. Sections cover planning and pre-start checks, SWP and SWMS review, hazard identification, permit requirements, MSDS or SDS awareness, correct tools and equipment, body posture and manual handling, driving and operating practices, PPE selection and condition, and isolation and tagging. Verify communication, responsible person, housekeeping, and general compliance. Record positive feedback, raise actions to address at-risk behaviors, and sign off observations.

by Stiza Te Moananui, from the Community

20+

Get

Template

Mining Safe Act Observation Checklist

Use this mining Safe Act Observation checklist to analyze and correct behaviors and site conditions. Sections cover risk assessment, permits, housekeeping, driving, tools and equipment, PPE, isolation and tagging, people positions, procedure compliance, and environment. Capture document details, site, time, observers, and record corrective actions and discussions with responsible personnel. Adapt this template to your operations and regulatory requirements.

by Hendrikus Engelbrecht, from the Community

30+

Get

Template

Behavior Observation Pink Card Form

Use this behavior based safety observation card to document safe and at risk actions during field work. The template includes sections for site, date, location, PPE checks for eyes, head, hands, hearing, breathing, feet, and body, as well as body positioning, line of fire, pinch points, lifting technique, ergonomics, attention and situational awareness. Capture work practices, communication, permits, tool and equipment use, housekeeping, and temperature considerations. Record observer notes, safe behaviors, at risk behaviors, and comments from the worker, then log corrective actions to drive continuous improvement.

by Kent Evatt, from the Community

20+

Get