Title Page

  • Job name and number

  • Conducted on

  • Client

  • Supervisor

  • Prepared by

  • Subcontractor/Employees

  • Work being performed at time on inspection

General

  • Swms onsite and adequate for purpose?

  • Swms signed by all workers and safety plan filed in correctly including writing of their ticket numbers

  • There are no incidents or notes from last week to focus on?

  • Pre start and toolbox up to date? Done daily

  • Guardrail handover certificate complete?

  • Safety mesh handover complete?

  • Exclusion zones, visual warning and or signage around work area where practicable

  • Photos of exclusion zones, visual warning and or signage around work area where possible.

  • Are materials onsite stacked neatly and bunted to prevent materials being run over or someone injuring themselves.

PPE

  • Hard Hats worn at all times even on roof?

  • Suitable steel cap shoes/boots worn by all workers?<br>Boots only on ground?

  • Gloves suitable for the task being worn?

  • Safety glasses being worn?

  • Hearing protection being worn?

  • Hi Vis being worn by all workers?

Electrical

  • Is the electrical register up to date?

  • All electrical items tagged and in date - must be within 3 month period

  • Works, materials and plant outside electrical exclusion zones - 3m low voltage and 6m for high voltage?

Fall Protection Equipment

  • Is the harness register onsite and in date? (within 6 monthly check period)

  • Check harness tags. Are there harnesses out of date on site? Must be within 6 month check period.

  • Do all workers have a working at heights ticket? (Check the ticket section of the safety plan)

  • Are suitable anchor plates / static lines in use?

  • Is the system suitable for intended use (considering pendulum effect and minimum fall heights)?

  • What rescue equipment is available?

  • Are workers trained in rescue equipment?

Ladders/Trestles/Mobile scaffolds

  • Is an industrial extension ladder is use for access only?

  • 3 points of contact at all times on ladders, extended 1m past landing and fixed at top and or bottom?

  • Mobile scaffold is set up as per manufactures instructions (up to 4m high)

  • Suitable for the task?

Roof Access/Edge Protection

  • Industrial ladder secured at top and or bottom, extended 1m past roof (less than 7.5m)

  • Suitable scaffold stairs?

  • Scaffold system is complete - no missing parts, correct rail heights?

  • Guard rail is complete with access point?

  • Workers are not climbing over handrails?

  • Is there a suitable visual barrier in place?

  • Is the access positioned at least 3m from lower voltage power lines?

EWP

  • Only licensed operators are operating the EWP?

  • Log book and safety check is completed daily?

  • Correct PPE worn for EWP and attached to the correct designated position?

  • EWP is being used within the SWL limit?

  • EWP is adequate for the job?

  • Positioned at least 3m from low voltage power lines?

  • EWP exclusion zone, visual warning and or signage around area where reasonably practicable?

  • Photo of EWP work area

House Keeping

  • Are materials on roof and ground secured with strapping?

  • Photo of materials

  • Is cleaning being done progressively?

Incidents/Notes

  • Incidents/notes:

  • Add media

Signature

  • Add drawing

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.