Behavior Based Safety Survey

This survey is designed to be filled out on an ipod or other portable touchscreen. For this reason, I'm using radio buttons rather than drop down lists.

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Behavior Based Safety Survey

2010-11-18
Lar-Farge
Tom
Western/Calgary
Safety Officer
Pipe Fitter
Event Free Tool Use
Needs Improvement
Improper rigging.

Understands Task

Peer Review

Co-Worker Coaching

Verbal Communication

Last Minute Risk Assessment

Safety Performance

Preparation & Planning

Pre & Post job analysis

Safe Work Practices

Technical Expertise

House Keeping

Work Procedure & Quality

Equip Labeling & Condition

Worker Knowledge & Skill

Lessons Learned

Clear Expectations

Other