QMF 413 Weekly Scaffold Inspection Checklist

• Date of Inspection

  Date

• Inspection Completed By

• Location
  Address

• Client

• Scaffold Erected By

Access

• Ladder, stairway, or special-design framing is installed for access

  Yes

  No

  N/A

Footings

• Scaffold on stable footing and a firm foundation

  Yes

  No

  N/A

• Base plates in place as required

  Yes

  No

  N/A

• Sole boards in place as required

  Yes

  No

  N/A

• No signs of undermined footings

  Yes

  No

  N/A

Bracing

• Diagonal cross bracing is in place to support legs

  Yes

  No

  N/A

• No missing or loose bracing

  Yes

  No

  N/A

• Correct fittings in use

  Yes

  No

  N/A

Boarding

• Working level platform(s) fully planked between guardrails

  Yes

  No

  N/A

• No missing or damaged boards in use

  Yes

  No

  N/A

• Boards satisfactorily supported

  Yes

  No

  N/A

• Boards secured to prevent movement

  Yes

  No

  N/A

• Platform is free of debris and slipping/tripping hazards

  Yes

  No

  N/A

Standards

• Standards are Plumb

  Yes

  No

  N/A

• Standards are not all joined at same height

  Yes

  No

  N/A

• Correct spacing of standards

  Yes

  No

  N/A

• Standards in good condition with no damaged standards in use

  Yes

  No

  N/A

Couplings

• Correct fittings in use

  Yes

  No

  N/A

• Secure with no loose couplings

  Yes

  No

  N/A

• Good condition and no damaged couplings

  Yes

  No

  N/A

• Check couplers in place where required

  Yes

  No

  N/A

Guard Rails & Toe Boards

• Platform guardrails are firmly in place on all open sides/ends, where required

  Yes

  No

  N/A

• Falling object protection is provided by installed toe boards on all sides

  Yes

  No

  N/A

• Guard rails and toe boards fitted at correct height

  Yes

  No

  N/A

• Edge protection in place with no guard rails missing

  Yes

  No

  N/A

• Guard rails securely fitted and not loose

  Yes

  No

  N/A

• Edge protection in good condition and not damaged

  Yes

  No

  N/A

Ledgers

• Ledgers are level

  Yes

  No

  N/A

• Ledgers are not joined in same bays

  Yes

  No

  N/A

• Ledgers securely fitted and not loose

  Yes

  No

  N/A

• Ledgers in good condition and not damaged

  Yes

  No

  N/A

Ties

• Sufficient ties in place

  Yes

  No

  N/A

• Ties securely fitted and not loose

  Yes

  No

  N/A

• Ties in good condition and not damaged

  Yes

  No

  N/A

Ladders

• Ladders are sufficient length

  Yes

  No

  N/A

• Ladders are tied securely

  Yes

  No

  N/A

• Ladders are in good condition

  Yes

  No

  N/A

Inspection Conclusion

• Scaffold in safe condition and no action required

  Yes

  No

  N/A

• Scaffold to be removed from service and repaired

  Yes

  No

  N/A

• RESULT OF INSPECTION:

  PASS

  FAIL

• Inspected By

• Contractor:

• Inspector Name:

• Signature:

  Sign