Title Page

  • Client

  • Date and Time of Inspection

  • Inspected by

  • Location

General Information

  • Description of work

  • Take a photo of the work area

  • List the names of workers


  • Does the facility have the permit to operate?

  • Take a photo of it

  • Do workers have a safe route to their place of work?

  • Is the site tidy and well laid out?

  • Are all people on site wearing the correct personal protective equipment?

  • Are people working on site inducted on the safety procedures?

  • Are workers suitably trained in using a harness?

  • Are harnesses, lanyards and other safety gear checked and evaluated?

  • Are safety tests conducted before the use of harness?

  • Are there systems in place for consultation with workers on safety, health and welfare matters?

  • Are First-Aid facilities in place and do workers know where they are?

  • Are safety nets used in place for fall protection systems?

  • Are there no obstructions between the work area and the net?


  • Is harness worn properly and attached to secure anchorage?

  • REFERENCE: Harness worn properly and attached to secure anchorage
    [This is an example of how you can use iAuditor to include best practice reference images in your templates to assist with inspections]

  • Do lanyards, anchorages, and lifelines support standard body weight?

  • Does equipment function in accordance with the manufacturer's recommendations?

  • Has the worker been assigned a shock-absorbing lanyard for his own use?

  • Has the worker been assigned an approved travel restraint or life line rope for his own use?

  • Does the worker have his own rope grab?

  • Are positioning device systems used so a worker on an elevated surface can have both hands free?


  • Have any components that have been subjected to an impact been removed from service?

  • Are there no suggested change in the equipment used?

  • Do workers talk to supervisor about health and safety concerns and possible changes/training?


  • Write down positive observation


  • Provide recommendation


  • Inspected by (Name and Signature)

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.