Coached Observation
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AM/PM Option
Coach
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Observer Coached
First Name
Last Name
1. GO TO THE ACTION
Does the observer have all their observation supplies and appropriate PPE?
Good
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Does the observer treat workers with respect?
Good
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Is the observation positive in approach?
Good
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2. OBSERVE OPENLY
Does the observer mention "no-name blame" process and explain the CBI if needed?
Good
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Does the observer mention there will be feedback at the end of the observation?
Good
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Does the observer avoid arguments?
Good
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3. DURING THE OBSERVATION
Does the observer look at the big picture? Check out the situation for accident potential?
Good
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Does the observer look for every behavior on the data sheet that is applicable to the task?
Good
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Does the observer mark all the "safe" and "at risk" behaviors that are observed?
Good
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Does the observer stop the observation before an accident occurs?
Good
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4. VERBAL FEEDBACK
Does observer discuss "safes" first?
Good
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Is "safe" feedback specific and thorough?
Good
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Does observer ask if there are any "safe" behaviors that they did not notice?
Good
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Are at- risk behaviors discussed next?
Good
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Does observer ask if there are any "at-risk" behaviors that they did not notice?
Good
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Does the observer ask for ideas on how to do the job more safely?
Good
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Does observer offer positive suggestions?
Good
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Did the observer agree to try to do the safe behavior next time or take action if beyond their control?
Good
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5. WRITTEN COMMENTS
Are comments written clear and specific?
Good
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Are the "While", "Was", "Because", "Suggestion", and "Try" completed?
Good
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Does the observer show data sheet?
Good
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6. END OF OBSERVATION
Does the observer thank the observee for the opportunity to do the observation?
Good
Work On
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