Form 32 Risk Based Audit Checklist for Scaffolding

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Select date

  Date
• Add location
  Address

Administration and Organization

• For specialised scaffoldings (e.g Hung/Suspended, load bearing, tubular above 40 meter). Designed and approved by competent person or Professional Engineer and drawing must be made available.

  Yes

  No

  N/A

• Levels of competency of workers meet DOSH requirements. (eg. Level 2 or advanced scaffolder)

  Yes

  No

  N/A

• Are inspection tags available and periodically revalidated (weekly or other specified interval)?

  Yes

  No

  N/A

• Is the scaffold inspected by a competent scaffold inspector?

  Yes

  No

  N/A

• There is a minimum high power line (415 kV) clearance of 10 feet from the scaffold

  Yes

  No

  N/A

Scaffold Structure & Working platform

• If the scaffold is defective, has it been removed from service and tagged out

  Yes

  No

  N/A

• Footing are level, sound, and rigid. No settling has occured

  Yes

  No

  N/A

• Are proper sole plates used for uneven surfaces? e.g. soft soil, grating?

  Yes

  No

  N/A

• Are barricade and warning signs installed to protect against moving vehicles and objects?

  Yes

  No

  N/A

• Are the tubes, fitting and floorboards free from signs of damage or deterioration e.g. rusting, sufficient thickness, not split, rotten?

  Yes

  No

  N/A

• Are the working platforms free from obstruction, loose objects, debris and tripping hazards?

  Yes

  No

  N/A

• Are floorboards adequately secured and with a minimum width of 635 mm (2 feet)?

  Yes

  No

  N/A

• Are guardrails fitted and connected up to standards (i.e. height to top of guardrails is between 0.9 and 1.1 metres.)?

  Yes

  No

  N/A

• Is toe board installed at the working platform level?

  Yes

  No

  N/A

Access and Egress

• Is there a safe access and egress to working platforms?

  Yes

  No

  N/A

• Is barricade chain or hand rails available at working platform?

  Yes

  No

  N/A

• Cross braces are not bended / damaged

  Yes

  No

  N/A

• Hook -on and attachable ladder are fixed securely and in good condition

  Yes

  No

  N/A

Supporting Structure & Anchoring Points (e.g. structures where scaffoldings are secured or anchored to)

• Are supporting structures / equipment (e.g. outriggers) adequate to support scaffolding?

  Yes

  No

  N/A

• Unsuitable equipments e.g. pipings, cable trays etc are not used as supporting structure

  Yes

  No

  N/A

• Is the structure covered with proper netting? (optional)

  Yes

  No

  N/A

• Add signature

  Sign