Date:		
Area(s) examined:		
Follow-up actions:		

 RATING CRITERIA	
Not Observed	Low	Medium	High	
NA	1	2	3	
Personnel Selection:	Observations	Rating	
1.	Do we formally record which roles require specific safety competence, experience or qualifications?			
2.	Do we take safety competencies, experience and qualifications into account when selecting personnel to a role or position?			
3.	Do we ensure that only once staff gain these competencies (or are in the process gaining them) are they allowed to undertake the work?			
Personnel Training:	Observations	Rating	
4.	How do we identify training needs? If so, where do we record it?			
5.	How is training delivered (i.e. theory vs on-the-job) and is it effective? 			
6.	How do you ensure that the training provided is applied in practice?			
Equipment and Machine Design:	Observations	Rating	
7.	How often do we examine the way staff use equipment or apparatus to ensure it is being used safely?			
8.	Is there a small change we can make to equipment or apparatus to make it safer and easier to use and further reduce the probability of human error?			
Job and Task Design:	Observations	Rating	
9.	When was the last time we reviewed the job or task and tried to see whether it can be modified or improved to make it safer?			
10.	Is there another way to do the job or task which will further reduce error and increase comfort and safety?			
Environmental Design:	Observations	Rating	
11.	Do we review or examine the working environment to see whether it continues to be comfortable and safe for staff to work in?			
12.	Do we have a schedule which outlines how often this is done?			
13.	What small changes could be made that would make the environment more comfortable and safer for staff to work in?			
ACTIONS:
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