Observation — Workplace Safety Assessment

SECTION 1 OF 9

Overview

Site *

Date *

Describe the task, location on site, trade and environment (weather, how busy) *

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 a previous observation

SECTION 2 OF 9

Scope of Work

Have you reviewed the scope of work? Familiar with client specifications? How did materials/equipment get to site? *

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. Emergency procedures, exclusion zones. *

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 on-site inductions? *

Yes No — action required

Assembly point(s) and nearest medical facility? *

SECTION 5 OF 9

PPE & Competency

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

Are 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

SWMS and/or SSSP completed for the task and being followed? *

LPSA, Take 5 and 360 Awareness being conducted? *

Work area barricaded safely? Line of Fire protection in place? *

LOTO in place? Each worker with own lock and tag? What test confirmed isolation? *

Tools and equipment? Condition, suitability, test tags, calibration? *

Vehicle reviewed? WOF, REGO, fire extinguisher, first aid kit? *

SECTION 7 OF 9

SDS, Workmanship & Client

SDS reviewed? PPE requirements for any substances on site? *

Task being completed to a high standard? Any defects in workmanship? *

Talk to the site operator — are they happy with our service? *

Work area neat and tidy? Good housekeeping maintained? *

Yes — good housekeeping Needs improvement — see notes

SECTION 8 OF 9

Outcome & Actions

All items identified as areas for improvement — how addressed, who responsible, by when? *

Root cause(s) and contributing factors? *

Does anything require follow up? *

SECTION 9 OF 9

Overall Safety Rating

Rate the overall safety of the site and workers *

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

Your name (observer completing this observation) *

Any additional comments or feedback

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

Workplace safety observation

Observation Submitted!