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Planned Task Observation - 0

The document describes a planned task observation form used to observe tasks and procedures at a work site. The form includes sections to record details of the observation like location, observer information, the task being observed, related documents, behavioral and procedural observations, discussion and feedback, and an action plan.

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Wafrika Technologies
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131 views

Planned Task Observation - 0

The document describes a planned task observation form used to observe tasks and procedures at a work site. The form includes sections to record details of the observation like location, observer information, the task being observed, related documents, behavioral and procedural observations, discussion and feedback, and an action plan.

Uploaded by

Wafrika Technologies
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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THENJIWE SUPPLIES & REPAIRS

Reference Number TSR/PTO/001


Implementation Date 03.12.2018
Revision / Amendment Number 0
PLANNED TASK OBSERVATION
Revision / Amendment Date 03.12.2018

SITE NAME:

Date: Time:
Location of Observation:
Observer/s :
Name Signature:

Own Contractor
Yes No Contractor Yes No Company
Employees
(Name):
Person/s Observed

Name: Surname Signature: Name: Surname Signature:

Name: Surname : Signature Name: Surname Signature

[ ] Strata Control [ ] Inappropriate emergency [ ] Working at Height


Related Fatal [ ] Fire and Explosions [ ] Explosives and Shot firing [ ] Lifting and Cranage
Hazards [ ] Mobile Equipment [ ] Inadequate Energy Isolation [ ] Confined space
[ ] Inrush and Outburst [ ] Drowning [ ] Electrical Safety
Observation
Type of [ ] Coaching PTO [ ] Task [ ] High Risk Work
Observation Verification
Task /Activity
Observed:

Document/s used [ ] RA Proc [ ]STD [ ] Permit to Work [ ] Check List [ ] Other


Related Documents Doc No: Doc Title:

Attach to PTO

Behavioural Observation
1 Standards 5 Tools & Equipment 9 Environment

2 Procedures 6 Housekeeping 10 Health Factors


(noise/ergonomics/
dust
Categories 3 Positions of 7 PPE 11 Other-specify
people/mobile
equipment

4 Manual handling 8 People related Factors


(unsafe position, unsafe work
speed)
Cat No Observations Discussion/Feedback
THENJIWE SUPPLIES & REPAIRS
Reference Number TSR/PTO/001
Implementation Date 03.12.2018
Revision / Amendment Number 0
PLANNED TASK OBSERVATION
Revision / Amendment Date 03.12.2018

Procedural Observation
Did the employee follow and
adhere to the task/procedure
steps?
No of Task Steps:
Step No Good Practices/ Discussion/Feedback
Deviations

Did the person/s being observed show competence in carrying out this task? [ ] Yes [ ] No
Is the procedure practical and easy to follow? [ ] Yes [ ] No
Recommendation:
THENJIWE SUPPLIES & REPAIRS
Reference Number TSR/PTO/001
Implementation Date 03.12.2018
Revision / Amendment Number 0
PLANNED TASK OBSERVATION
Revision / Amendment Date 03.12.2018

Action Plan
No Action Who When

Approval of Action Plan

Name: _________________ Designation:_________________ Signature: _______________


Date:_______________

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