BUL Site Evaluation

BUL Site Evaluation

This document is to be completed once per visit to a company project or satellite facility by a Business Unit Leader.
Business Unit*
Project / Office / Warehouse Location*
Referred to as "Site" in the questions.
Project Number (if applicable)
If Applicable
Project Leader:*

First NameLast Name
Project Leader / Project Manager:*
Field Leader:*
Conducted By:*
Conducted By:*

First NameLast Name
Date Conducted:*

MonthDayYear
Date
Were you given a safety brief by a field leader prior to touring the site covering the hazards and protections you should be aware of?*

YesNo
How would you rate our housekeeping on the site?*

ExcellentGoodPoorFair
How would you rate our safety culture on the site?*

ExcellentGoodPoorFair
How would you rate the customer's satisfaction with our safety effort and results?

ExcellentGoodPoorFair
How would you rate our leadership culture of the site?*

ExcellentGoodPoorFair
Plan of the Day Meeting
Did you attend a pre-shift Plan of the Day meeting?*

YesNoNot Applicable
Was safety discussed?

YesNo
Was the site safety professional present and involved?

YesNo
Team Member Interview: Select a random craft worker, introduce yourself, and ask them if they are willing to answer a few questions.
Name of person you interviewed:

First NameLast Name
Does the start of the shift safety meeting and safety documents prepare you to work safely that day?*

YesNo
Has the company supplied you with the correct equipment and training to work safely?*

YesNo
Select one of the following Leadership Influence in Safety questions from the drop down list and record the employee's answer in the space below.*
Employee's answer:*
Additional General Comments:
Enter your email address if you want a copy of the completed evaluation:
example@example.com
Should be Empty: