Title Page
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Client / Site
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Conducted on
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Prepared by
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Location
General Information
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Description of work to be performed
Scaffolding Safety Discussion
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Common scaffold hazards include unstable bases, inadequate footings and cross bracing, unsafe access and absence of guardrails and defective platforms.
Here are general requirements on safety precaution:
• All scaffolds are to be capable of supporting, without failure, at least 4 times the maximum intended load.
• Never allow debris/materials to collect on scaffold.
• Always use netting to catch anything that falls.
• Make sure scaffold is secure.
• Do not stand on ties, guardrails, or extensions.
• Do not overreach outside the guardrails.
• Stay off scaffold during loading or unloading.
• Replace guardrails after loading or unloading.
• Use 3-point climbing.
• Don’t hang tarps without evaluation.
• Exit mobile scaffolds before moved.
• Always wear fall protection to avoid accidents.
Follow up questions
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Are there any reported damaged scaffold?
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Take a photo of damaged scaffold
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Is the scaffold removed from service?
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Is there any hazard happened during the shift?
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What are those hazards?
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Any question or comment about these safety precautions?
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What are the questions needs to clarify?
Completion
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Competent Person (Full Name and Signature)
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By signing this, you confirm that the information discussed during this meeting were fully understood.
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Click + to add signee
Employee
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Employee (Full name and signature)