Title Page
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Client / Site
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Conducted on
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Prepared by
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Location
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Do workers have safe access to the site?
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Do workers have adequate access to drinking water, toilets, and other sanitary facilities?
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Are workers wearing proper PPE for the task they are performing?
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Are workers protected from live electrical work?
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Are extension cords and tool cords in good shape (no damage to cord, ground prongs intact)?
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Are workers using GFCI protection?
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Are there any scaffolds on site?
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Is the scaffold type/weight rating appropriate for its current use?
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Is the competent person on site?
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Has the scaffold been inspected before use?
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Is the base/bearing adequate?
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Do workers have adequate access to the scaffold?
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Is scaffold braced, guyed, or tied to building adequately?
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Are decks 100% planked?
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Are planks adequately lapped or secured?
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Are planks rated for use as scaffold planks?
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Are workers who are working over 10' high protected from falls?
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Any other scaffold issues?
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There any trenches more than 4 feet deep on site?
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Is the Competent Person on site?
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Are workers in the trench protected from cave-in or collapse via shoring/shielding, benching, or sloping?
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Is there a ladder or other means of egress within 25 feet of travel of workers?
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Any other trench issues?
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Are door and wall openings guarded to protect workers from falls of more than 6 feet with top rail at 42" high and midrail at 21" high?
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Are floor openings greater than 2" guarded or covered properly?
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Are workers using PFAS properly and as needed?
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Any other fall protection issues?
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Are there forklifts being used on site?
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Is the operator qualified as defined by OSHA?
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Has the forklift been inspected before use?
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Is the forklift being used to lift workers with an aerial work platform?
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Has the platform been inspected before use?
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Are all workers on the platform wearing full body harnesses connected to an approved anchorage point?
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Describe any other safety issues (worker safety or public safety) on site?