Title Page

  • Site conducted

  • Conducted on

  • Conducted By:

  • Location (i.e. Rusholme)
  • Specific Area Inspected (i.e Wind Turbine Number / Workshop etc..)

  • Scoring Criteria
    Compliant – No shortfalls identified, criteria met or standards required achieved
    Partially Compliant – Minor shortfalls identified in the standard or requirement, minor opportunities for improvement identified and the standard is still to an acceptable level. (For Example -PAT Testing – Most items tested and in date however a few units have been missed)
    Non-Compliant – The standard or requirement has not been achieved and deemed to be unacceptable. Immediate action is required to address the shortfall/s (Example – PAT Testing – Most items out of date and not tested)

  • Fixed Collective Protection – Hand rails, ladders, flooring / grating are in good condition and fit for purpose? Pre Use checks carried out on service lift prior to use? (Protection must prevent fall from height)

  • Temporary Collective Protection - Scaffolding tagged and in date? Temporary working platforms (i.e. Zip Up platform) in good condition and inspected, and Installed by a competent person? (Ensure any temporary opening where a fall from height is likely has a fixed barrier in place i.e. Barrier tape to prevent fall from height risk is prohibited)

  • Falling Items – Items that could fall to a lower level, risking damage or injury must either be secured or contained / exclusion zones established. (i.e. Toe boards fitted, tethers in use, equipment contained within containers. Check condition of tethers and personal tool bags)

  • Risk Assessment & POWRA conducted? – Teams working at height must have conducted a risk assessment. The working party members should have been briefed on the requirements of controls from this process. Are the control measures stated in place?

  • Fall Restraint – Is the correct fall restraint system being used and in date? (Must be controlled via preventing physical access to fall point. Using a correct length lanyard (secured to a fixed point). In the case of MEWP`s it should not be possible for the person in the basket to climb out once attached.

  • Fall Arrest- Is the correct arrest system being used and in date? (i.e. Full body harness / twin lanyards / slider). Buddy checks conducted prior climbing?

  • Inspection of PFPE- All Personal Fall Protective Equipment is inspected and within its thorough examination date?

  • Information – Adequate signage / demarcation in place to alert others to risks either above or below?

  • Emergency Arrangements - Is a rescue plan available for the task? Rescue equipment available and within inspection date? Suitable Communications established? Are individuals trained and competent to enact the rescue plan?

  • Portable Ladders – Ladders must be tagged and secured. Used only for short duration activity. They should be the correct size and on a firm surface. Pre use check conducted on potable ladders prior to use?

  • Fixed ladders / access gates to roofs / unauthorised areas– Ladders/gates that are part of fixed plant or building (Excluding WTG) must be protected via a locked plate/lock door preventing use / entry without authorisation.

  • NOTES:

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.