Ladder Safety Checklist

• Ladder Reference #

• Client / Site

• Date Purchased

  Date
• Location
  Address

• Conducted on

  Date

• Prepared by

General Information

• Take a photo of the ladder

  Media

• Take a photo of the tag or label

  Media

• Type of ladder

  Portable

  Self-supporting

  Non-self supporting

  Other

• Enter type of ladder

• Ladder Material

  Wood

  Metal

  Fiberglass

  Aluminum

• Length

Ladder Safety Inspection

• Is the ladder placed on level ground? Is the ladder placed on level ground?

  Yes

  No

  N/A

• Do the ladder rungs run parallel (horizontally) with the floor?

  Yes

  No

  N/A

• Is the ladder fixed at regular intervals or do you have a stability device in place to prevent it from slipping and falling?

  Yes

  No

  N/A

• Is the top of the ladder resting against a strong surface, such as a brick wall?

  Yes

  No

  N/A

• Is the ladder at a 75° angle – 1 unit out for every 4 units up?

  Yes

  No

  N/A

• Has the ladder been checked for defects before use?

  Yes

  No

  N/A

• Are the feet missing, worn or damaged?

  Yes

  No

  N/A

• Are the rungs and stiles bent or damaged?

  Yes

  No

  N/A

• On a stepladder, does the locking mechanism engage fully?

  Yes

  No

  N/A

• Are the steps or feet free of dirt?

  Yes

  No

  N/A

• Has a regular formal inspection of the ladder been done?

  Yes

  No

  N/A

• Other defects observed?

• Take a photo of other defects (optional)

  Media

Recommendations

• Please write here

• Overall Rating

  Good

  Needs Repair

  N/A

Completion

• Full Name and Signature of the Inspector

  Sign