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SAFETY FOLLOW UP WORKSHEET
Please input all fields marked with *
Name :
*
Hire Date :
*
Dept :
*
Jobsite :
*
Initial :
Topic :
Company safety policies and programs.
Safety rules, both general and specific to jobsite and assignment.
Safety rule enforcement policy and related disciplinary procedures.
Where, When and How to report injuries, accidents and near misses.
Where, When, and How to report unsafe conditions.
Location of Fire extinfuishers and fist aid kit.
Requirements for safe work clothing and footwear.
Importance of house keeping to avoid spills, trip hazards and other unsafe conditions.
Special job hazards specific to jobsite or task.
Required type and use of PPE.
Proper lifting and material handling techniques.
Demonstration and understanding of stretch and flex.
Smarter not harder specific task observation and coaching.
Task:
Observations and recommendations:
Line of fire specific task observation and coaching.
Task:
Observations and recommendations:
Supervisor Signature:
*
Clear Signature
Date:
Employee Signature:
*
Clear Signature
Date:
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