JSA (Job Safety Analysis) Checklist
Boost workplace safety with our comprehensive JSA (Job Safety Analysis) checklist for manufacturing! Identify hazards, analyze risks, and create effective controls. Downloadable & customizable for any manufacturing process - ensure employee well-being and prevent costly accidents. #JSA #ManufacturingSafety #SafetyChecklist #JobSafetyAnalysis #WorkplaceSafety
This Template was installed 2 times.
Job Identification & Information
Details about the specific job being analyzed.
Job Title
Department
Location (Specific Area)
Job Number / ID (if applicable)
Date of JSA Creation
Brief Description of Job
Frequency of Job
Is this a new or existing job?
Employee(s) Performing Job (Primary)
Job Steps Breakdown
A detailed listing of each sequential step involved in the job.
Step Number
Step Description
Detailed Explanation of Step (if needed)
Estimated Time to Complete Step (e.g., minutes)
Specific Location of Step (e.g., Machine ID, Workstation)
Resources Required for this Step
Date Step Typically Performed (if recurring)
Hazard Identification
Identifying potential hazards associated with each job step. Consider all aspects - physical, chemical, ergonomic, biological, etc.
Describe the potential physical hazards present (e.g., noise, vibration, sharp edges, moving machinery)
Describe any potential chemical hazards (e.g., fumes, dust, liquids)
Potential Ergonomic Hazards?
Identify any potential biological hazards (e.g., bacteria, viruses, mold)
Are there any confined space concerns?
Describe any potential fall hazards
Estimated Noise Level (dB)
Any other hazards observed?
Risk Assessment (Severity & Probability)
Evaluating the potential severity of harm and the likelihood of occurrence for each identified hazard.
Severity Rating
Probability Rating
Severity Score (Numerical)
Probability Score (Numerical)
Risk Score (Severity x Probability)
Justification for Ratings
Risk Level (Derived)
Control Measures
Identifying and documenting specific controls to eliminate or mitigate the identified risks. Consider Hierarchy of Controls (Elimination, Substitution, Engineering Controls, Administrative Controls, PPE).
Hierarchy of Controls Applied (Check all that apply)
Detailed Description of Engineering Controls Implemented
Specific Procedures/Work Instructions Updated or Created
Frequency of Safety Checks/Inspections for Equipment (e.g., daily, weekly, monthly)
Details of Additional Training Required (beyond standard job training)
Administrative Controls Implemented (Check all that apply)
Specific Details of PPE Required and its Proper Usage
Personal Protective Equipment (PPE)
Specifying required PPE for each job step and ensuring proper fit and usage.
Required PPE for this job:
Specific Glove Type & Material (if applicable):
Respirator Type & Fit Testing Information (if applicable):
Any PPE Modification or Special Considerations:
PPE Inspection Frequency (e.g., Daily, Weekly, Monthly):
Last PPE Inspection Date:
Employee Acknowledgement of PPE Requirements:
Training & Communication
Documenting training requirements for the job and ensuring clear communication of hazards and controls.
Brief Description of Training Provided
Topics Covered in Training (Check all that apply)
Number of Employees Trained
Date of Training
Trainer Name
Employee Acknowledgement of Training
Notes on Communication Methods Used (e.g., toolbox talks, posters)
Review & Approval
Signatures and dates to confirm review and approval of the JSA.
JSA Completion Date
Job Analyst Signature
Supervisor/Manager Approval
Reviewer Name (if different from analyst)
Date of Last Review
Review Interval (months)
Comments/Notes (regarding review and approval)
Revision History
Tracking changes made to the JSA over time. Include date, reason for change, and initials of who made the change.
Revision Date
Revision Number
Description of Changes
Prepared By (Initials)
Prepared Signature
Reviewed By (Initials)
Reviewed Signature
Equipment & Tools Checklist
Verifying that necessary equipment and tools are available, in good working order, and used correctly.
Equipment Condition - Visual Inspection
Equipment Last Inspection Date (YYYY-MM-DD)
Tool Condition - General
Essential Tools Required
Specify Specialized Tool (if selected above)
Guard Placement
Calibration Status (if applicable)
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