Preventive Safety Observation Card Guide
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ScribdTranslationsPreventive Safety Observation Card Guide
Translated by
ScribdTranslationsFecha Aprobación:22/03/2022
PREVENTIVE OBSERVATION CARD
SECURITY (TOPS)
Review: 0
REPORT DATE NAME OF THE REPORTER N.- CARD
TYPE OF REPORT LOCATION (Please specify one)
UNSAFE ACT Administrative Offices Grocery store Booth Entry
Parking lot of
UNSAFE CONDITION Stairs Waste area
Campamento
INCIDENT Operation of Equipment Teams
POLLUTION Driving of Area of
AMBIENTAL Vehicles Maintenance
Cashier Area
OTHER Painting Area
Electrical
DEFINITIONS
Unsafe Act: Any human action that endangers the safety of people, property or the environment. E.g.
Operate equipment without authorization.
Unsafe Condition: It is any dangerous situation that puts the safety of people, property, or the environment at risk.
environment. E.g. Wet Floor.
Incident: Where no negative effect on health, injury, damage, or other loss has occurred; but it could
to become a work accident.
Environmental pollution: Environmental presence of agents (chemical-biological) that may be harmful to health.
security or environment.
Other: Any suspicious activity or changes in daily life, environment, surroundings, or people where it takes place.
the activities.
DESCRIBE THE OBSERVED NOVELTY
RECOMMENDED MEASURES TAKEN
UNSAFE ACT
Operate equipment without authorization Work under the influence of alcohol and/or
drugs
Driving at an inappropriate speed Using defective equipment or machinery
Incorrectly lifting loads Adopting poor posture at work
Not using PPE correctly Playing or joking at work
Perform maintenance on the equipment in Inadequate storage of
operation waste
Improper handling of equipment Use inappropriate tools
Not complying with policies and procedures Others
UNSAFE CONDITIONS
You guard inappropriate barriers Fire or explosion hazard
Tools, equipment, defective materials Excessive noise
Extreme temperatures Defective pallets
Leaks or leaks from machinery and equipment Equipment without maintenance
Lifting elements in poor condition Contact with electric currents
Order and cleanliness Slippery surfaces or unevenness
PPE in poor condition or defective Others
As a result of the observation, was it reported to your immediate boss or the supervisor?
STOP WORK Authority area?
YES NO
YES NO If your answer was affirmative, please indicate:
Name:
Card of
By filling out this card,
Observation keep in mind that with
your help will contribute to
Preventive of
prevention of
Security accidents at your place
of work