OBSERVATION REPORT

Form
SECTION 1 – THE ISSUE OBSERVED
Raised By: Raised When:

From What Branch: Phone Number:

What Is The Issue? (Describe all available detail ):

What Have You Done/Do You Need Done About It?

SECTION 2 – QUICK ASSESSMENT – ACTION TAKEN/REQUIRED

Passed To: Initial Receipt Accepted :

Received When:

This issue is a: Incident (See Incident Management)

Suggestion for an OFI
Injury (See Injury Management)
Customer Inquiry Possible Sale/Work
Environmental/Quality Problem
Quick Assessment – Action Taken/Required:
Complaint To Resolve
Hazard/Risk To Assess/Manage
Training Employee Skill Knowledge
Other_____________________________.

SECTION 3 – THE ISSUE RESOLVED

Passed To: Received When:

To close this issue, the following is to/has occurred:

This Issue Is:

With CAT Team The Action Plan Is Being Implemented Closed Out Feedback Given
FRM-ALL-1026 -2 OBSERVATION REPORT Issued: 19 July 2007
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SECTION 2 – QUICK ASSESSMENT – ACTION TAKEN/REQUIRED CONTINUED
Quick Assessment – Action Taken/Required:

SECTION 3 – THE ISSUE RESOLVED (CONTINUED)

To Close This Issue The Following Is To/Has Occurred:

FRM-ALL-1026 -2 OBSERVATION REPORT Issued: 19 July 2007

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OBSERVATION REPORT
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Overview. All issues/incidents reported using th ree step Observation Report :

• Step 1 – Identify issue & report to nearest responsible person ,
• Step 2 –Develop solution & raise the necessary reports or escalate the issue ,
• Step 3 – Responsible person & Branch Management fix the problem & record
actions taken. Observation reports are triple carbonised with three sections :
Identifying & Reporting. All personnel , including management , are to have &
use an Observation Report which is used to report all issues including : hazards , near
misses, incidents , or injuries , equipment /plant deficiencies , customer complaints ,
concerns , complaint or dissatisfaction , to record management site visits , customer
quality concerns /opportunities , feedback from staff to an employee on performance ,
breaches of procedure , poor performance , non -compliance , ideas as Opportunities
for Improvement any other event of concern or abnormality .
Person observing issue , completes Section 1 of the Observation report .
WHITE COPY Passed to Responsible Person,
YELLOW COPY Passed to CAT Team,
GREEN COPY Kept by Observer
NOTE: If the person making the observation can fix the problem they should do so .
Develop a Solution. Responsible person receives Observation Report and they :
• Initial the triplicate form as a proof of receipt & retain the White copy
• Assess situation & resolve if possible recording the action taken on Section 2,
• If the issue requires more information ie injury etc then the responsible person
collects the information & reports this in the relevant form ,
• If the issue is not resolved provide guidance & escalate the issue further ,
• Pass the Observation Report to the Branch Management
Fix Issue Record Action Taken. Responsible person develops solution
complete Section 2 detailing action taken & pass to Branch Management who :
• Record the action on the CAT Actions Register
• Raise the Observation Report with the CAT Team
• Sign-off the Observation Report as complete in Section 3 & provide feedback .
• If issue involves injury then Incident report raised immediately & the Injury
Management & Return to Work proce ss followed
• If incident involves insurance claim then appropriate processes to be followed .
OBSERVATION REPORT
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START:

Issue Identified/Event Occurs

Observer Does What They Can To Assist

Resolve Issue. Stop Work If Necessary
Until Issue Resolved .

Start Observation Report – Section 1 Pass

To Responsible Person

Responsible Person Initials & Takes White

Copy. Conduct Quick Assessment .

STOP Work Escalate

Issue Resolved Onsite ? No Is Risk Acceptable ? No Issue Until Risk
Controlled
Yes
Yes Escalate Issue For
Resolution.
Record Results of Quick Assessment In
Section 2

The Responsible Person may need after the Quick Assessment to raise
further reports and paperwork such as: Incident Report & Investigation,
Motor Vehicle Accident Report in Navision etc . If necessary the original
Observer of the issue may need to be taken back to the Branch/Doctor etc
to complete the process.

Issue Passed To Branch

Management to Either Resolve or
Review & Confirm Action Taken By
Responsible Person

Is Action So Far Provide Immediate Direction To Manage Issue. Refer To

Acceptable. Can Issue No CAT Team, Develop Solution or Escalate To Corporate
Be Closed? Assurance.

Yes

Close Out Issue

Enter to Branch Actions Complete Section 3 of

END: Register Observation Report
Document History
Versi Reason for change Previous Authorised Date
on Document No by
No.
1 New Document D. Arundale 1 May 2007
2 Add Reference Only D. Arundale 19 July
2007