Form ini digunakan untuk mengevaluasi efektivitas pelaksanaan safety talk guna meningkatkan kualitas komunikasi keselamatan kerja di area operasional.
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Tanggal Pelaksanaan
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Tanggal Pelaksanaan
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Judul Materi Safety Talk
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Judul Materi Safety Talk
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Nama Pemateri
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Nama Pemateri
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Berapa Jam Durasi Tidur ?
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Berapa Jam Durasi Tidur ?
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Bagaimana Kualitas Tidur ?
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Bagaimana Kualitas Tidur ?
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Buruk
Cukup
Baik
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Bagaimana Keadaan Hari Ini ?
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Bagaimana Keadaan Hari Ini ?
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Segar Bugar
Sedikit Lelah
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Sangat Lelah
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Section 2 of 5
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1. Bagian Kesatu
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Materi dan Relevansi
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Materi dan Relevansi
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Sangat Kurang
Kurang
Cukup
Baik
Sangat Baik
Materi yang disampaikan relevan dengan pekerjaan saya sehari-hari.
Topik yang dipilih sesuai dengan potensi bahaya yang ada saat ini.
Materi mudah dipahami dan tidak berbelit-belit.
Durasi pelaksanaan Safety Talk sudah tepat (tidak terlalu singkat/lama).
Rows
1.
Materi yang disampaikan relevan dengan pekerjaan saya sehari-hari.
2.
Topik yang dipilih sesuai dengan potensi bahaya yang ada saat ini.
3.
Materi mudah dipahami dan tidak berbelit-belit.
4.
Durasi pelaksanaan Safety Talk sudah tepat (tidak terlalu singkat/lama).
1.
Other:
5.
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Columns
Sangat Kurang
Kurang
Cukup
Baik
Sangat Baik
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Section 3 of 5
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2. Bagian Dua
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Cara Penyampaian
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Cara Penyampaian
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Sangat Kurang
Kurang
Cukup
Baik
Sangat Baik
Pemateri menguasai materi yang disampaikan.
Suara pemateri terdengar jelas oleh seluruh peserta.
Materi yang disampaikan pemateri bermanfaat untuk pekerjaan sehari hari
Rows
1.
Pemateri menguasai materi yang disampaikan.
2.
Suara pemateri terdengar jelas oleh seluruh peserta.
3.
Materi yang disampaikan pemateri bermanfaat untuk pekerjaan sehari hari
1.
Other:
4.
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Columns
Sangat Kurang
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Sangat Baik
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Section 4 of 5
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3. Bagian Ketiga
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Dampak & Implementasi
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Dampak & Implementasi
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Sangat Kurang
Kurang
Cukup
Baik
Sangat Baik
Safety talk membantu meningkatkan kewaspadaan terhadap bahaya kerja
Instruksi keselamatan dapat langsung diterapkan di pekerjaan
Rows
1.
Safety talk membantu meningkatkan kewaspadaan terhadap bahaya kerja
2.
Instruksi keselamatan dapat langsung diterapkan di pekerjaan
1.
Other:
3.
Add row
or
add "Other"
Columns
Sangat Kurang
Kurang
Cukup
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or
add "Other"
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Section 5 of 5
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Saran
Description (optional)
Topik apa yang ingin Anda bahas pada Safety Talk berikutnya?
*
Question
Topik apa yang ingin Anda bahas pada Safety Talk berikutnya?
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Date
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Saran untuk perbaikan pelaksanaan Safety Talk ke depannya
*
Question
Saran untuk perbaikan pelaksanaan Safety Talk ke depannya
*
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Multiple choice
Checkboxes
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Rating
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
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Length
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Minimum character count
Number
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Answer key
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Tanggal Pelaksanaan
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Judul Materi Safety Talk
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Nama Pemateri
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Berapa Jam Durasi Tidur ?
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Bagaimana Kualitas Tidur ?
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Bagaimana Keadaan Hari Ini ?
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1. Bagian Kesatu
Materi dan Relevansi
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2. Bagian Dua
Cara Penyampaian
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3. Bagian Ketiga
Dampak & Implementasi
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Saran
Topik apa yang ingin Anda bahas pada Safety Talk berikutnya?
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Saran untuk perbaikan pelaksanaan Safety Talk ke depannya
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