Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Has the scaffold been constructed and loaded in accordance with the design of a qualified person with a safety factor of at least 4 to 1?

  • Has the maximum load capacity of this scaffold been communicated to all affected employees?

  • Is the load on the scaffold (including point loading) within the maximum load capacity of this particular scaffold?

  • Are scaffolds and scaffold components inspected before each work shift by a competent person?

  • Have employees who erect, disassemble, move, operate, repair, maintain, or inspect the scaffold been trained by a competent person to recognize the hazards associated with this type of scaffold and the performance of their duties related to this scaffold?

  • Have employees who use the scaffold been trained by a qualified person to recognize the hazards associated with this scaffold and understand their duties related to it?

  • Is the scaffold plumb, square, and level?

  • Are all the working platforms fully planked? ( with less than 1" spaces between planks or between the planks and uprights )

  • Where the employer can demonstrate the necessity, is the gap between the last plank and the uprights less than 9 1/2 inches wide?

  • Are all working platforms at least 18 inches wide?

  • Are the planks overlapped over supports?

  • Are all abutted planks resting on separate support surfaces?

  • Do planks extend at least 6 inches and no more than 12 inches over the supports?

  • Are planks scaffold grade or equivalent?

  • Are the planks in good condition and free of splits, cracks, cuts, or other damage?

  • Does the scaffold have all required guard rails and toe boards?

  • Is screening installed between the toe board and top rail where personnel are required to work or pass underneath?

  • Are the tops and bottom surfaces of scaffold planks visible and free from paint or other opaque coverage?

  • Are the open sides of the scaffold less than 14 inches from the face of the work?

  • If open sides are more than 14 inches from the face of the work, is there proper fall protection available?

  • Are platforms either extending over the centerllines of their supports by at least six inches, or cleated , or restrained by hooks?

  • Where scaffold components from different manufacturers are used, do they fit together without force and has their use been determined to be safe by a competent person?

  • Has a competent person approved use of any dissimilar metals?

  • Are scaffold frames braced in accordance with the manufacturers instructions?

  • Are 4:1 (height to width) scaffolds secured to a building or structure as required?

  • Have ties been installed at a horizontal member that supports the inner and outer legs?

  • Has the first vertical tie been installed at a height less than 4 times the minimum base dimension?

  • Have vertical ties been repeated every 20 feet or less for scaffolds that are 3 feet or less in width?

  • Are ties installed at each end of the scaffold structure and at no more than 30 foot horizontal intervals?

  • Are scaffolds erected on firm foundations?

  • Is the scaffold on base plates and are mudsills level, sound and rigid?

  • Are footings able to support at least 4 times the maximum intended load without settling? (beware of frozen / thawing ground)

  • Have scaffolds which are occupied been prohibited from movement?

  • Do scaffolds meet the clearance requirements from power lines?

  • Are slippery conditions on scaffolds corrected before workers are permitted to use them?

  • Where stormy conditions or high winds exist, has the competent person been consulted and wind screen or personal fall arrest systems been put to use?

  • Is additional bracing installed to compensate for overturning forces such as of extension platforms or weather wraps?

  • Are the scaffolds kept free from debris?

  • Is safe access provided for all scaffold platforms that are more than 2 feet above or below the point of access?

  • Has climbing cross braces been prohibited?

  • Have ladders been positioned so as not to tip the scaffold?

  • Is the bottom rung of the ladder less than 24 inches above the supporting surface?

  • Are guard rails, including mid rails, installed on all opens sides and open ends of the platform?

  • If no guard rails are installed, is fall protection provided?

  • Are floor holes (2 inches or more in the least dimension) and skyllights guarded by appropriate coverings or railings?

  • Are window and wall openings less than 39 inches from sill to floor protected with railings?

  • Are guardrails installed at a height between 36 and 45 inches?

  • Does the guardrail system meet the necessary strength requirements?

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.