Sample: Job Task Analysis Form - OSACH



Sample Job Task Analysis Form

A Job Task Analysis should be completed for each task in a job.

All completed Job Task Analysis (JTA) forms should be kept in a central location so they can be accessed by management when conducting training on the task.

|Job Title: |  |

|Name of Task: |  |

|Supervisor: |Hours Worked per Week: |

|Outline of Job Duties: | |

| | |

| | |

| | |

| | |

|Physical Job Demands |  |

|Grade activity frequency according to scale below by circling the most appropriate number on the following form. |

|0 - not required |3 - occasionally required (12-25 times/shift) |

|1 - seldom required (1-5 times/shift) |4 - frequently required (26-70 times/shift) |

|2 - minor requirements (6-11 times/shift) |5 - always required (71+ times/shift) |

|  |  |

|Where applicable, grade weight requirements according to scale below by circling the most appropriate lower case letter. |

|a- limited (up to 5 kg) |c - medium (10 kg but less than 20 kg) |

|b- light (5 kg but less than 10 kg) |d - heavy (more than 20 kg) |

|  |  |

|Grade activity duration according to the scale below by circling the most appropriate upper case letter on the following form. |

|A - minimal (0 to 1 hour/shift) |D - continuous (over 5.5 hours/shift) |

|B - occasional (1 - 2.5 hours/shift) |C - frequently (2.5 - 5.5 hours/shift) |

| |E - never |

|Comments section should identify mechanical or physical aids recommended or required as well as any additional information pertaining to the |

|physical activity being performed. |

 

Note: Job Task Analyses should be completed on all jobs within your company.

[This form has 3 pages]

|Physical Activity |Specification |Frequency |Weight |Duration |Comments |

|BENDING |at waist |0 1 2 3 4 5 | |A B C D E | |

| |stooping |0 1 2 3 4 5 | |A B C D E | |

| |kneeling |0 1 2 3 4 5 | |A B C D E | |

| |crouching |0 1 2 3 4 5 | |A B C D E | |

| |crawling |0 1 2 3 4 5 | |A B C D E | |

| |squatting |0 1 2 3 4 5 | |A B C D E | |

|WALKING |level surface |0 1 2 3 4 5 | |A B C D E | |

| |rough ground |0 1 2 3 4 5 | |A B C D E | |

| |slopes |0 1 2 3 4 5 | |A B C D E | |

| | | | | | |

|CLIMBING |stairs |0 1 2 3 4 5 | |A B C D E | |

| |ladders |0 1 2 3 4 5 | |A B C D E | |

| | | | | | |

|SITTING |chair |0 1 2 3 4 5 | |A B C D E | |

| |stool |0 1 2 3 4 5 | |A B C D E | |

| |vertical seat |0 1 2 3 4 5 | |A B C D E | |

| | | | | | |

|STANDING | |0 1 2 3 4 5 | |A B C D E | |

| | | | | | |

|BALANCING | |0 1 2 3 4 5 | |A B C D E | |

| | | | | | |

|REACHING |overhead |0 1 2 3 4 5 | |A B C D E | |

| |forward |0 1 2 3 4 5 | |A B C D E | |

| |side |0 1 2 3 4 5 | |A B C D E | |

| | | | | | |

|NECK POSTURES |flexion |0 1 2 3 4 5 | |A B C D E | |

| |extension |0 1 2 3 4 5 | |A B C D E | |

| |rotation |0 1 2 3 4 5 | |A B C D E | |

| |side flexion |0 1 2 3 4 5 | |A B C D E | |

| | | | | | |

|SHOULDER |abduction |0 1 2 3 4 5 | |A B C D E | |

| | | | | | |

|POSTURE |flexion |0 1 2 3 4 5 | |A B C D E | |

| | | | | | |

|WRIST |flexion |0 1 2 3 4 5 | |A B C D E | |

| | | | | | |

|POSTURE |extension |0 1 2 3 4 5 | |A B C D E | |

| | | | | | |

|HANDLING |fine manipulation |0 1 2 3 4 5 |a b c d |A B C D E | |

| |gross manipulation |0 1 2 3 4 5 |a b c d |A B C D E | |

| |hand tool usage |0 1 2 3 4 5 |a b c d |A B C D E | |

| | | | | | |

|LIFTING |from ground |0 1 2 3 4 5 |a b c d |A B C D E | |

| |from bench |0 1 2 3 4 5 |a b c d |A B C D E | |

| |over shoulder |0 1 2 3 4 5 |a b c d |A B C D E | |

| |over head |0 1 2 3 4 5 |a b c d |A B C D E | |

| | | | | | |

|CARRYING | | |a b c d |A B C D E | |

| | | | | | |

|PUSHING | | |a b c d |A B C D E | |

| | | | | | |

|PULLING | | |a b c d |A B C D E | |

| | | | | | |

|WRITING | |0 1 2 3 4 5 | |A B C D E | |

| | | | | | |

|TYPING | |0 1 2 3 4 5 | |A B C D E | |

 

ENVIRONMENTAL CONDITIONS:

|Indoor/ Outdoor (circle one of both) |Temperature (average) |

|Noise level (approximate) |Required Safety Equipment |

|Dust/Mist/Vapour/Gas (yes or no) |Equipment/Tools Used |

Notes:

|Completed by: |Position: |

| | |

|Date Completed: | |

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