Name of auditors:
Task being undertaken (description and title):
Activity (Planned or Unplanned)
Name of company:
Task Supervisor details:
Person being audited
Are they working at heights?
Are they HVO Work at Heights trained?
Date of last training?
Sight evidence of work at heights tickets
How often do you do this task?
Are you familiar with this task / equipment?
Are you authorised for this piece of equipment (if applicable)
Can you show me your pre-start inspection?
Did you identify anything wrong in your pre-start inspection?
How would you know if something was not fit for purpose?
What did (or would you do) if it was not fit for purpose?
Pick one element of the pre start / pre use inspection and ask the person to demonstrate how they would check it
Compare todays pre start against previous pre starts. Were there any issues identified on previous pre-starts that are not on the current pre start. If yes, has it been repaired and if neccessary re-inspected?
What equipment is being used?
- Coloured band
- Date tag
- Scaffold tag
- Service label
Colour of test tag?
Check equipment is in date
What inspection process was used and by whom?
Is all equipment being used fit for use?
If applicable service label / test tag is appropriately signed / certified (e.g. a scaffold tag must be signed by a certified scafffolder) Record the name and check competent and authorised to sign off?
If applicable, where and how would a person wearing a harness fall?
If applicable, are any in use working at height designated attachment points (painted pink and labelled) included on the approved attachment register?
If applicable, is working at heights equipment included on the register?
If applicable, are all ladders in use labelled, identifiable and included on a service and inspection register?
If applicable, confirm workers task is not exceeding equipment weight requirements (e.g. weight specified by scaffold tag, EWP etc.?
Record permit number
Permit signed by whom?
All sections completed as required?
Detailed emergency rescue plan for fall victims correctly accounts for the likely situation in the event of an emergency?
Is permit sign off competent in working at heights / understand the risks?
Are all persons locked on as required (if applicable)?