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Safety observation card template
A safety observation card is the form behind a behavior-based safety (BBS) program. An observer, often a supervisor or a peer, watches a task for a few minutes, marks each behavior safe or at risk, then talks with the person: recognizing what was done safely and agreeing how to fix what was not. The card carries no name of the person observed, because the point is to find patterns, not culprits. Page 1 of this template has four cards to cut out, with ten common behaviors across PPE, body position, lifting, tools, equipment, procedures, the work area and traffic, plus a blank row for your own. Page 2 is a tally sheet that adds up the cards by behavior, with % safe, follow-up actions and a week-by-week record.
Free to use: print it, copy it and edit it for your team. Enter your name and work email once to download.
Four cut-out cards on one sheet, each with fields for area, date, time, observer and task, a checklist of ten behaviors with safe and at-risk boxes, whether the observer talked with the person, lines for praised, discussed and agreed, and a follow-up box.Four cards per sheetTen behaviors, safe or at riskConversation and feedbackFollow-up neededTally with % safeWeek-by-week record
When to use it
When to use safety observation cards
- To run a behavior-based safety program on paper, or to trial one in an area before going further.
- On a scheduled safety walk by supervisors, or peer to peer within a team.
- When incident or near miss reports point to the same behaviors, such as lifting or the line of fire.
- To recognize safe work, not only to correct at-risk work.
How to fill it in
- 1
Agree the behaviors
Use the ten on the card or replace them with the ones that matter in your area. Keep the list short enough to watch in a few minutes.
- 2
Tell people how it works
Explain that the cards carry no names and are not used for discipline, and that the observer will talk with them afterwards.
- 3
Observe for a few minutes
Watch a task, then tick safe or at risk for each behavior you saw. Leave the rest blank.
- 4
Have the conversation
Thank the person for what was done safely, ask about anything at risk and agree what to change. Note it on the card.
- 5
Tally the cards
Each week or month, add up safe and at risk for each behavior on page 2 and work out % safe.
- 6
Fix the causes
For the behavior seen most at risk, look for the cause in the job, such as a tool out of reach or a blocked walkway, and give the fix an owner and a date.
A filled-in example
Illustrative, not a benchmarkAn example: four weeks of observation cards in a stamping area, collected by supervisors and team leads.
The example four weeks of cards
Conversations held ÷ cards
- 58 ÷ 64= 91%
Lowest % safe: hands clear of pinch points71%
64 cards, a conversation held on 58 of them, 91 percent. The lowest behavior, hands clear of pinch points, was 71 percent safe.
- 64 cards, with a conversation held on 58 of them.
- Lowest % safe: hands clear of pinch points, at 71%, seen at risk mostly while clearing jams.
- Cause found in the job: the jam-clearing hook was kept at the next press, so operators reached in by hand.
- Follow-up: a hook on a marked holder at every press, and a one point lesson on clearing jams.
In the next four weeks the tally showed pinch-point behavior mostly safe, and the team moved on to the next lowest behavior, lifting at the coil station.
Common mistakes
Using cards for discipline
Once a card leads to a warning, people stop working normally when watched and stop talking. Keep names off and say so.
Ticking without talking
The conversation is where behavior changes. A card with no conversation is a count, not coaching.
Only looking for what is wrong
Recognizing safe behavior matters as much. Note what was done well.
Blaming the person for the job
At-risk behavior often comes from the job: a missing tool, a guard that slows the work, a target that rushes people. Fix those.
Collecting cards nobody reads
Tally them, act on the lowest behavior and tell the team what changed.
Download the template
Free to use: print it, copy it and edit it for your team. Enter your name and work email once to download.
Run this template in LeanSuite
In LeanSuite supervisors and peers log safe and at-risk behaviors on a phone by category, such as PPE, line of fire or ergonomics; an at-risk answer can raise a tag or an action, and dashboards show which departments need coaching.
See it in a 45-minute demoIn the lean glossary
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FAQ
Safety observation card template: common questions
A short form an observer uses to record the safe and at-risk behaviors seen during a task, and the conversation held afterwards. It is the main tool of a behavior-based safety program.
A program in which observers record safe and at-risk behaviors and use the results to coach people and fix the conditions behind unsafe habits, before they lead to injuries.
No. Cards without names keep the focus on patterns and causes, and people work more naturally and talk more openly when they know a card cannot be used against them.
Set a number each observer can keep up every week and track it on the tally sheet. A steady rhythm of observations with real conversations matters more than a high count.
Talk about them on the spot, then tally them. For the behaviors seen most often at risk, look for the cause in the job and fix it, and use short training where a skill is missing.
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- Manufacturing KPI dashboard templateWeekly plant numbers in, 14 KPIs out: OEE and its parts, first pass yield, scrap, on-time delivery, recordable rate, cost and absence, each against a target.
- RCM worksheet (failure mode and task selection)Failure modes classed as hidden, safety, operational or non-operational, then a task chosen for each: condition-based, discard, failure-finding, redesign or run to failure.
- Error-proofing verification log (daily master-sample check)Each poka-yoke device proved every day or week with a known-bad sample, with missed checks counted and the hours and parts at risk worked out when one fails.
- Downtime reason codes template26 starter codes mapped to the six big losses, a log with drop-downs, a Pareto by code and by loss, and a code card for the line.
- Defect catalogue template with boundary samplesEvery defect with a definition, a class and the reason for it, measured accept and reject limits by zone, boundary samples, a defect log with DPU and Pareto, and an inspector agreement check.
- I-MR chart template (individuals and moving range)Up to 100 single readings with moving ranges, limits from a baseline, five run-rule flags, both charts, a second phase and a reaction log.
- Kaizen event preparation checklistEverything that has to be ready before a kaizen event and done after it: 44 items with owners and due dates from 6 weeks before day 1 to 30 days after, five go or no-go gates and a day-by-day agenda.
- Attribute control chart template (p, np, c and u charts)p, np, c and u charts in one workbook: a chart selector, a sample size check, limits for each subgroup, signal flags and four worked examples.
- Critical spare parts list and stocking levelsAssets ranked by consequence, each part classed and given a stocking policy, and min and max worked out from usage and lead time, with the downtime each stock-out would cost.
- Tier 2 meeting agenda and escalation sheetA 15-minute tier 2 agenda in ten timed blocks, fixed roles and rules, escalation triggers with time limits, and a log that ages every escalation and sends the answer back down.
- Mock recall template: traceability exercise worksheetTrace a finished lot back to every input lot and forward to every first customer, reconcile the quantities against a tolerance and time it against your target.
- ISO 9001 internal audit checklist (production area)46 audit questions for the production floor in 11 processes, each with its ISO 9001:2015 clause, what evidence to look for and the sample to take, plus five defined grades, a findings log, a finding report and a summary by clause.
- Plan for every part (PFEP) templateOne row per part: supplier, pack, container, usage, lead time and locations, with ABC classes, market and line kanban counts and a lineside space check.
- Food plant GMP inspection checklist (21 CFR 117 subpart B)55 checks in the order of 21 CFR 117 subpart B, each citing its paragraph and saying what to look at, with a grade, finding, owner and due date; results by section and grade, a walk route and a bakery example.
- Master sanitation schedule with pre-op verificationA master list of cleaning tasks by area and equipment with frequency, chemical, lockout, who and next due date, a weekly on-time count, and the pre-operational verification log with a release step.
- Changeover matrix templateA from-to matrix of changeover minutes with the clean each transition needs (allergen, colour, format), and a weekly planner that totals the order and suggests a shorter one.
- Measurement uncertainty budget templateA GUM uncertainty budget: Type A and B rows, divisors by distribution, sensitivity coefficients, uc, νeff, k from the t-table, U, TUR and a guard band check.
- Maintenance job plan templateOne job planned on one sheet: steps and craft hours, parts checked against stock, tools, lockout and permits, documents, a ready check for the schedule, and technician feedback.
- Video time study filming checklistA pre-shoot checklist and shot log for filming a time study on video: camera, light, people, settings, power and review.
- Reorder point and safety stock sheet (many parts)Safety stock, reorder point, order quantity and an order list for up to 500 parts, worked out from each part's own demand and lead time history.
- Energy use and EnPI trackerMonthly electricity, gas and fuel in one unit, a 12-month regression baseline, expected against actual energy for each month, an EnPI ratio, the running saving and the tests that say whether the model can be trusted.
- FIFO lane sizing sheetThe maximum for a FIFO lane from the stop it must cover, in whole containers, with length, refill and wait checks for up to eight lanes.
- Pugh matrix templateCompare up to 8 concepts with a datum as better, same or worse on up to 12 criteria, flag must-haves, and carry the strongest into a second round.
- Condition monitoring route sheetA route of measuring points with baselines, alert and alarm limits, a check interval from the P-F interval, readings with rising and overdue flags, and an exceptions list worst first.
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A shift handover sheet, a red tag log, a changeover checklist for one machine: if your team uses it on the floor, ask.