SAFE Observation 

General Information

Location

Conducted By Email

What Kind of SAFE Observation Type?

Food AccountFacility AccountRSG Account

What Kind of Facility Observation would you like to complete?

General Observation

Cleaning Facilities

SAFE Observation: Food

Store heavy items at waist level? Safe Unsafe N/A

Area clear of trip hazards?   Safe Unsafe N/A

No lifting above the shoulders?

Safe

Unsafe

N/A

Area clear of slip hazards?

Safe

Unsafe

N/A

Power Up: Lift with your legs?

Safe

Unsafe

N/A

Master cleaning schedule is utilized?

Safe

Unsafe

N/A

Feet First: Turn with your feet?

Safe

Unsafe

N/A

Sanitizer available at right concentration?

Safe

Unsafe

N/A

 Employees wash hands when necessary?

Safe

Unsafe

N/A

Foods are wrapped & Labeled?

Safe

Unsafe

N/A

Available and in good Condition?

Safe

Unsafe

N/A

Hot foods are hot and cold foods are cold?

Safe

Unsafe

N/A

PPE In Use?

Safe

Unsafe

N/A

Suggestions/Feedback:

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SAFE Observation: Facilities

Store Heavy Items at Waist Level?

Safe

Unsafe

N/A

Area clear of trip hazards?

Safe

Unsafe

N/A

No lifting above shoulders?

Safe

Unsafe

N/A

Area clear of slip hazards?

Safe

Unsafe

N/A

Power Up: Lift with your legs?

Safe

Unsafe

N/A

Check wheel conditions?

Safe

Unsafe

N/A

Feet First: Turn with your feet? 

Safe

Unsafe

N/A

Hand Protection?

Safe

Unsafe

N/A

Push hand trucks and carts?

Safe

Unsafe

N/A

Eye Protection?

Safe

Unsafe

N/A

Suggestions/Feedback:

Slip-resistant footwear in good condition?

Safe

Unsafe

N/A

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SAFE Observation: Uniforms

Area clear of hazards? 

Yes

No

PPE: Hand protection?

Yes

No

Check Emergency stops?

Yes

No

  

Path is free of moving objects? 

Yes

No

Slip-resistant footwear?

Yes

No

Work area and aisles clear?

Yes

No

   

Alignment: Lifting with your legs?

Yes

No

Vehichle Seatbelt is used?

YesNoN/A

Carts/Casters in good condition?

Yes

No

  

Repetition: Rotate muslce groups?

Yes

No

Social Distancing: Are we compliant?

Yes

No

Hand Sanitizers: Are they easily available?

Yes

No

Eyes on Path: Clear View of Pathway?

Yes

No

Facial Coverings: If required, are they worn?

Yes

No

Suggestions/Feedback

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SAFE Observation: Facilities Cleaning

Avoid twisting and reaching?

Safe

Unsafe

N/A

Slip-resistant shoes? 

Safe

Unsafe

N/A

Push/Don't pull?

Safe

Unsafe

N/A

Wear eye protection mixing chemicals?

Safe

Unsafe

N/A

Power up with legs?

Safe

Unsafe

N/A

Use work gloves when cutting?

Safe

Unsafe

N/A

Signage/Area clear of slip hazards?

Safe

Unsafe

N/A

Remove trip hazards?

Safe

Unsafe

N/A

Inspect equipment prior to each use?

Safe

Unsafe

N/A

Other Unsafe Conditions?

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