Title Page

  • Conducted on

  • Prepared by

  • Location
  • Client

  • Personnel on site

  • Do all scaffolders have a valid CISRS Card

  • Is there a current copy of the RAMS on-site

  • Is there a TG20 Compliance certificate available for the job

  • Is there an authorised permit for close work on-site

  • Is there an authorised travel permit on-site

  • Is there a Fire Extinguisher in the vehicle

  • Is the Fire Extinguisher within service date

  • Is there a First Aid box in the vehicle

  • Are the items in the first aid box sufficient and within the expiry date

POWRA - (Point Of Works Risk Assessment)

  • Is there a relevant POWRA on site

  • Does the area where the scaffold is being erected correspond with the POWRA

  • Has the scaffold area been cordoned off from pedestrians

  • Stop work and erect the protection zones

  • Is the vehicle parked safely and had cones placed around it

  • Has there been a set down area designated safe from pedestrians

Scaff Steps

  • Serial Number of Scaff Step 1

  • Condition of Scaff Step 1

  • Serial Number of Scaff Step 2

  • Condition of Scaff Step 2

The Scaffold

  • Are base plates in use

  • Are base plates in good condition

  • Are sole boards in use

  • Are sole boards in good condition

  • Is the scaffold being erected in line with SG4 (single handrail on all non boarded lifts, operatives clipped on)

  • Is there foam pedestrian protection on the base standards & braces where required

  • Are operatives using a step ladder whilst basing out

  • Is the ladder in good condition

Covid Measures

  • Are all operatives working within the Covid guidance

  • Are masks being worn where the 2m rule cannot be adhered to

  • Is there evidence that the vehicles regular touchpoints have been wiped down as per guidance

Images

  • Add images of the site here

Sign off

  • Auditor

  • Signature

  • Date

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