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Position:
Person Interviewed:
Date:
What are the hazards and the associated risk for this workplace?
What controls were put into place to control the risk and how effective are they?
Discuss and agree actions regarding these observations/interactions to close-out the meeting
Quality Criteria
YE
S
Did you give positive recognition? e.g. For Working Safely , Safe Behaviour, Safe Conditions
Did you assess the risks and hazards of the work the people were doing? (Did you ask the what if
questions?)
Have you discussed follow-up actions with people listed as responsible and set agreed timing for
closure?
NO