SMILE — Workplace Safety Assessment

SECTION 1 OF 9

Overview

Site *

Date *

Describe the task, where on site, the trade and comments about environment (weather, how busy is the site). Include images of the work area and task being performed. *

Photos of work area & task *

📷 Take or choose photos

Type of work being performed *

Why are you completing this observation? *

Random / Ad Hoc Observation Scheduled Observation Follow-up from previous SMILE

SECTION 2 OF 9

Scope of Work

Have you had the opportunity to review the scope of work? Are you familiar with the client specifications? What was the process to get materials/equipment to site? Describe any client-specific expectations. *

Photos of documentation (drawings, SSSP, SWMS, etc.)

📷 Take or choose photos

SECTION 3 OF 9

Work Environment & Safety Controls

Describe the work environment and steps taken to keep it safe. Inside or outside? On a roof, in a confined space? How has a safe working area been made and maintained? What would workers do in an emergency? *

Is this a higher risk task? List any HRCs (Higher Risk Checklists) being used. *

Photos of work area, barricading, exclusion zones *

📷 Take or choose photos

SECTION 4 OF 9

People & Inductions

Names of worker(s) completing this task *

Are you performing this observation on a subcontractor?

Yes No — Clarksons staff

If subcontractor — list their employee names

Have workers signed into site visitors book and completed any on-site inductions? *

Yes No — action required

Where are the assembly point(s) and nearest medical facility? *

Photos of site sign-in register / induction records

📷 Take or choose photos

SECTION 5 OF 9

PPE & Competency

Is PPE appropriate and aligned with client and SWMS requirements? Worn correctly and in good condition? *

Are the technicians trained and competent to complete this task? *

Photos showing PPE in use / qualification documents

📷 Take or choose photos

SECTION 6 OF 9

Documentation & Controls

Has a SWMS and/or SSSP been completed for the task and is it being followed? *

Is LPSA, Take 5 and 360 Awareness being conducted? What issues have been noted and discussed? *

Is the work area barricaded safely? Has this been documented? Is Line of Fire protection in place? *

Is LOTO in place? Has each worker added their own lock and tag? What test method confirmed isolation? *

What tools and equipment are being used? Condition, suitability, test tags, calibration? *

Has the vehicle been reviewed? WOF, REGO, RUC, service, fire extinguisher, first aid kit, ladders, roof racks? *

Photos of documentation, LOTO, equipment *

📷 Take or choose photos

SECTION 7 OF 9

SDS, Workmanship & Client

Has SDS been reviewed? What are the PPE requirements for any substances on site? *

Is the task being completed to a high standard? Are there any defects in workmanship? *

Talk to the site operator — are they happy with our service? Note any improvements or follow-up required. *

Is the work area neat and tidy? Good housekeeping maintained? *

Yes — good housekeeping Needs improvement — see notes

Photos of workmanship / housekeeping

📷 Take or choose photos

SECTION 8 OF 9

Outcome & Actions

List all items identified as areas for improvement. Include how they were addressed, who is responsible, and by when. *

For opportunities noted — why did they occur? Root cause(s) and contributing factors? *

Does anything require follow up? If so, what needs to happen? *

Photos of any improvement items or actions taken

📷 Take or choose photos

SECTION 9 OF 9

Overall Safety Rating

Rate the overall safety of the site and the workers *

1★ STOP work
call HSE 3★ Good,
meets expectations 5★ Nothing
could be better

Your name (observer completing this SMILE) *

Any additional comments or feedback about this assessment

By submitting this SMILE, you confirm all information is accurate and that any improvement items have been discussed with the relevant workers on site.

See · Manage · Identify · Learn · Eliminate

SMILE Submitted!