Title Page

  • Conducted on

  • Prepared by

  • Location

1. Site Conditions

  • 1.1 Adequate welfare facilities, clean, tidy and maintained?

2. Scaffold Surroundings

  • 2.2 Has public protection been provided?

3. Scaffolding Structure

  • 3.7 Are the scaffold/ties correctly positioned and correctly fixed as per the design/drawings?

4. Housekeeping

  • 4.2 Are all the spare materials in a neat and tidy condition?

5. Documentation

  • 5.1 Are the task-specific risk assessment and method statement present on-site?

  • 5.2 Is there a hand over certificate in place?

  • 5.3 Has the previous audit report been closed out?

6. Sign Off

  • 6.1 Name of person completing this report.

  • 6.2 Name of the site person receiving this report.

I confirm the contents of this report have been discussed with myself and I am aware of any issues highlighted in the body of this report.

7. Closure

  • 7.1 I confirm all actions highlight in this report have been actioned on:

Name of the person closing this report.

  • Add signature

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