Title Page

  • Conducted on

  • Prepared by

  • Location
  • Have you checked the CRIP rating – if the property is tenanted

  • Have you checked the property/surrounds risk information

  • Have you completed a SWP if needed

  • Have you arranged the visit as per established protocols and notified others

  • Is my secure locate activated

  • Is it safe to exit my vehicle

  • Is the site secure and safe to enter

  • Am I wearing the correct PPE

On site scaffolding

  • Is the tag valid (Present, Weekly inspection recorded and completed in full)

  • If the scaffolding exceeds 5 m in height has Worksafe been notified (Does not apply if single story units)

  • If the scaffolding exceeds 5 m in height has it been erected by a holder of a current certificate of competence

  • Is erected scaffolding within 4 m of any powerlines, If within 4 m have all signoff certification and permissions been given)

  • Is max load capacity of this type known, Indicated on tag and communicated to all employees

  • Is the scaffolding on baseplates to secure structure

  • Are sole boards or baseplates on even surfaces and secured to support structure and meet the required measurements of (500mmX200mmX38mm thick)

  • Is the scaffolding plump and square

  • Is Fall protection equipment required

  • Are all required guardrails, Mid rails, toe boards and trapdoors in place and also meet the spacing requirements of 300mm in between

  • Is there safe access to all work platforms

  • Are all scaffolding access ladders secured and safe to use for access and meet the 4:1 ratio

  • Are all platforms fully decked and tied down

  • Is structure secured with face and/or dogleg braces

  • Are self closing gates correctly installed

  • Is netting installed and secured where applicable to prevent falling

  • Are excess scaffolding material neatly stacked and stored

Mobile Scaffolding

  • Are excess scaffolding material neatly stacked and stored

  • Is erected scaffolding within 4 m of any powerlines, If within 4 m have all signoff certification and permissions been given)

  • Is max load capacity of this type known, Indicated on tag and communicated to all employees

  • Is the scaffolding plump and square

  • Is Fall protection equipment required

  • Are all required guardrails, Mid rails, toe boards and trapdoors in place and also meet the spacing requirements of 300mm in between

  • Is there safe access to all work platforms

  • Are all scaffolding access ladders secured and safe to use for access and meet the 4:1 ratio

  • Are all platforms fully decked and tied down

  • Is structure secured with face and/or dogleg braces

  • Is the tag valid (Present, Weekly inspection recorded and completed in full)

  • Scaffolding mobile equipment (Wheels) being locked while in stationary position.

  • Scaffolding mobile equipment (Wheels) mechanical lock in good and working condition

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.