Project Manager Project Evaluation

Project Manager Project Evaluation

The project evaluation form for PM's to use to gain valuable safety culture knowledge about the project.
Department*
Project Name:*
Project Number:*
Date of Evaluation:*

MonthDayYear
Date
Evaluation Conducted By:*

First NameLast Name
Names of Other Personnel Involved:
Email a copy to this address:
example@example.com
Crew or Area Evaluation: Pick one crew or area to evaluate, do not do the entire project.
Is the JSA complete, signed off by all of the workers, and signed by a project leader before work started?*

YesNo
Is the area free of trash and debris and housekeeping is acceptable?*

YesNo
Do personnel have safe access to the work area?*

YesNo
Are walking and working surfaces sufficient and safe?*

YesNo
Are the work crews attending Small Group Safety Meetings?*

YesNo
Do personnel working at heights have all tools tethered as required?*

YesNoNot Applicable
Are personnel working at heights tied to a correct fall protection anchor point?*

YesNoNot Applicable
Team Member Interview: Select a random creaft worker, introduce yourself, and ask them if they are willing to answer a few questions.
Craft:*
Time in trade:*
Do you believe the new hire orientation process prepared you to work on the site?*

YesNo
Does the start of shift safety meeting and JSA prepare you to work safely that day?*

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

YesNo
Does your Foreman make sure that you are in compliance with APi and Customer safety rules?*

YesNo
Do you feel comfortable reporting safety concerns/issues and incidents to your supervisor or safety professional?*

YesNo
If No, why not?
How often do you see a safety professional?*

Less than once a day.Once a day.2+ times a day.A safety professional is not assigned to site.
How often do you see your site leader?*

Less than once a day.Once a day.2+ times a day.
What could the company do to provide a safety work place?*
Total Project Questions:
Did you attend the Plan of the Day (POD) meeting?*

YesNo
If Yes, was the Safety Professional involved in the meeting?

YesNo
If Yes, was the Safety discussed at the meeting?

YesNo
How would you rate the POD meeting?

ExcellentGoodFairPoor
How would you rate API's overall safety culture on the site?*

ExcellentGoodFairPoor
How would you rate the API's overall leadership culture on the site?*

ExcellentGoodFairPoor
How would you rate the overall housekeeping of the site?*

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

ExcellentGoodFairPoor
How would you rate the customer's overall safety culture on the site?*

ExcellentGoodFairPoor
How would you rate the customer's overall leadership culture on the site?*

ExcellentGoodFairPoor
Additional comments on the site conditions and culture:
Should be Empty: