Fillable Observation Of Work Practices printable pdf download

Observation of Work Practices -

General

Employee Classification based on duration of Postal Employment

(Check one box)

1. Non-Career

2. 0-3 months (probationary)

3. 4-23 months

4. 2 years plus

Name of Employee

Sta/Br/Ofc

Date of Observation

Location of Observation

Task Observed

Time of Observation

From: _______________To: ______________

Observer: During the course of this observation you are to mark ( ) which activities observed,

if Yes,

if No. The observation is to be reviewed

with the employee immediately upon completion.

Yes

EQUIPMENT USAGE

EMERGENCY PREPAREDNESS

Yes

B1 Uses restraining bars or locks on APCs/OTRs

B34 Keeps aisles unblocked (at least 28 inches clearance)

B2 Red tags defective equipment

B35 Keeps exits unblocked

B3 Keeps from loading hard plastic trays over 20 lbs.

B36 Keeps fire extinguishers unblocked

B4 Loads sacks within weight limits

B37 Keeps electrical panels unblocked

B5 Keeps from overloading mail transport equipment

B38 Keeps fire alarms unblocked

CLOTHING

Yes No

B6 Sets brake on APC/OTR when stationary

B39 Wears proper shoes

B7 Lowers shelves/secures gates with “S” hook before moving

APC

B40 Hair is tied back or confined while around machinery

B8 Uses false bottoms in 1046 hampers when appropriate

B41 Does not wear loose clothing or jewelry around moving

machinery

EQUIPMENT MOVEMENT

Yes

B42 Wears only nitrile gloves, when working around

Pushes instead of pulls

machinery/automation

MAINTENANCE/CUSTODIAL

Yes No

B10 Pushes one piece of equipment at a time

B43 Stores tool/supplies when finished with task

B11 Controls equipment until it stops moving

B44 Places hazard signs up when washing or waxing floors

B12 Removes headphones when moving

B45 Uses appropriate personal protective equipment PPE)

B13 Watches were he/she is going

B46 Uses Lockout properly

LIFTING

Yes

MISCELLANEOUS

Yes No

B14 Lifts with legs, back straight

B47 Smokes only in designated area

B15 Asks for assistance with heavy pieces

B48 Uses correct entry and/or exit door

Yes No

B16 Avoids twisting while moving object

B49 Safe work practices were demonstrated

PERSONAL CARE

Yes

SAFE WORK PRACTICE RECOGNITION

B17 Does not jump, stand, ride over or on equipment, unless

equipment is designed for that use

B18 Is aware of objects/people around work area

B19 Does not throw objects except in approved mail

processing procedures

B20 Does not jump off the loading dock - uses stairs or ramp

RETAIL SERVICES

Yes

B21 Removes cash drawer using arms and legs – keeps back

B50 Unsafe practices, behaviors or acts were observed

straight and avoids twisting

WORK PRACTICES TO BE IMPROVED

B22 Unplugs equipment before attempting repair/replacement

B23 Keeps cabinets and drawers closed when not in use

B24 Closes safe doors with palms, not fingers

B25 Aisle is clear before depositing mail behind screen line

B26 Does not allow children to be set up on counter

REST BAR

Yes

B27 Seat is properly tilted and uses proper posture

Discussed with employee on:

B28 Keeps one foot on floor/base

B29 Stores properly

OBSERVER’S SIGNATURE/DATE

HOUSEKEEPING

Yes

Observer’s Name:

B30 Puts empty sacks or trays in proper place

Observer’s Signature:

B31 Picks up articles and trash lying on floor

B32 Places trash in proper receptacles as provided

Date:

Retention: 4 years

B33 Keeps case tops clear of objects

4589

Original: Employee

PS Form

, July 2007

Copy: Supervisor

Observation Of Work Practices

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