CONSTRUCTION WORKER SAFETY PERCEPTION SURVEY CHECKLIST

Created by ChecklistGuro (https://checklistguro.com)

--- PERSONAL PROTECTIVE EQUIPMENT (PPE) ---
[ ] Do you consistently wear your hard hat? (Always, Sometimes, Never)
[ ] Is your safety footwear in good condition? (Yes, No, N/A)
[ ] How many pairs of work gloves do you have available?
[ ] Are your safety glasses/goggles clean and scratch-free? (Yes, No, N/A)
[ ] Describe any issues youâ€™ve experienced with your provided PPE.
[ ] Do you feel your PPE fits correctly and comfortably? (Yes, No, Somewhat)
[ ] Upload a photo of your PPE (optional)

--- HAZARD IDENTIFICATION & REPORTING ---
[ ] Have you received training on hazard identification? (Yes, No, Not Sure)
[ ] Approximately how many hazards do you identify on a typical workday?
[ ] Which of the following methods do you use to report hazards? (Verbal Report to Supervisor, Written Report Form, Online Reporting System, Other)
[ ] Describe a recent hazard you observed and how you reported it.
[ ] Do you feel comfortable reporting hazards to your supervisor? (Yes, No, Sometimes)
[ ] If you answered 'No' or 'Sometimes' to the previous question, please briefly explain why.

--- TRAINING & COMMUNICATION ---
[ ] How clear were the safety instructions provided during your training? (Very Clear, Clear, Somewhat Clear, Not Clear)
[ ] Approximately how many safety training hours have you received in the last year?
[ ] Which of the following communication methods do you find most helpful for receiving safety updates? (Safety Briefings, Email, Posters/Signage, Team Meetings, Mobile App)
[ ] Do you feel comfortable asking your supervisor questions about safety procedures? (Yes, No, Sometimes)
[ ] Please provide any suggestions for improving the clarity or effectiveness of safety communication.

--- SITE SAFETY RULES & PROCEDURES ---
[ ] Are you familiar with the site's fall protection plan? (Yes, No, Unsure)
[ ] Do you understand the lockout/tagout procedures? (Yes, No, Unsure)
[ ] How often (in days) is a site safety meeting held?
[ ] Do you feel empowered to stop work if you identify an unsafe condition? (Yes, No, Unsure)
[ ] Please describe any specific site rules or procedures you find unclear or difficult to follow.
[ ] Are you aware of the emergency evacuation plan? (Yes, No, Unsure)

--- SUPERVISION & MANAGEMENT COMMITMENT ---
[ ] To what extent do you agree that management prioritizes safety over production? (Strongly Agree, Agree, Neutral, Disagree, Strongly Disagree)
[ ] How often do supervisors actively participate in safety meetings? (Always, Frequently, Sometimes, Rarely, Never)
[ ] Please provide specific examples of management demonstrating their commitment to safety (or lack thereof).
[ ] On a scale of 1-10 (1 being not at all, 10 being extremely), how would you rate management's responsiveness to safety concerns?
[ ] Do you feel comfortable raising safety concerns to your supervisor? (Yes, No, Sometimes)
[ ] If you answered 'No' or 'Sometimes' to the previous question, please explain why.

--- WORK ENVIRONMENT & ERGONOMICS ---
[ ] How would you rate the noise levels on site (1-10, 1=Quiet, 10=Very Loud)?
[ ] Is the lighting adequate for your tasks? (Yes, No, Sometimes)
[ ] Are your work surfaces at a comfortable height? (Yes, No, Sometimes)
[ ] Describe any ergonomic issues you're experiencing.
[ ] How many hours per day do you spend performing repetitive tasks?
[ ] Is ventilation sufficient? (Yes, No, Unsure)

--- INCIDENT REPORTING & INVESTIGATION ---
[ ] Were you comfortable reporting the incident? (Yes, No, Not Applicable)
[ ] Briefly describe the reported incident.
[ ] Was the incident reported to a supervisor? (Yes, No, Not Applicable)
[ ] Date of Incident Reporting
[ ] Time of Incident Reporting
[ ] Estimated number of workers potentially affected by incident
[ ] Do you feel the incident was investigated thoroughly? (Yes, No, Unsure)
[ ] If you feel the incident wasnâ€™t thoroughly investigated, please explain why.

--- NEAR MISS REPORTING ---
[ ] Have you ever witnessed a near miss? (Yes, No)
[ ] Briefly describe the near miss you witnessed (if applicable).
[ ] Did you report the near miss? (Yes, No, Not sure/Don't remember)
[ ] Approximately how long ago did the near miss occur (in days)?
[ ] If you did not report the near miss, please explain why.
[ ] Do you feel comfortable reporting near misses on this site? (Very Comfortable, Somewhat Comfortable, Not Very Comfortable, Not at all Comfortable)

--- OVERALL SAFETY CULTURE ---
[ ] How safe do you generally feel on this job site? (Very Safe, Safe, Neutral, Unsafe, Very Unsafe)
[ ] Do you feel comfortable speaking up if you have a safety concern? (Yes, always, Usually, Sometimes, Rarely, Never)
[ ] Describe the general atmosphere regarding safety on this site.
[ ] On a scale of 1-10 (1 being not at all, 10 being extremely), how much do you trust your supervisors to prioritize safety?
[ ] Which of the following best describe the overall safety culture (check all that apply)? (Proactive, Reactive, Blame-free, Punitive, Open Communication, Lack of Communication)
[ ] Do you believe that safety is a priority for management? (Yes, No, Unsure)

--- SUGGESTIONS FOR IMPROVEMENT ---
[ ] Please describe any specific safety concerns you have encountered.
[ ] What additional training or resources would help you feel safer at work?
[ ] On a scale of 1-10 (1 being not at all, 10 being extremely), how likely are you to report a safety hazard?
[ ] What is the primary barrier preventing you from reporting a safety concern? (Fear of Retaliation, Lack of Time, Uncertainty about Reporting Process, Believe Nothing Will Be Done, Other)
[ ] Which of the following improvements would most enhance site safety? (More frequent safety inspections, Improved signage, More accessible safety equipment, Increased toolbox talks, Better communication channels)
[ ] Any other comments or suggestions?

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