Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

DESIGN

  • Scaffold designed by a qualified person?

  • Scaffold designed to support 4x maximum intended loads?

SCAFFOLD SUPPORT

  • Scaffold erected, moved, dismantled of altered only under the supervision of a "Competent Person" and performed by trained employees?

  • Scaffold frames resting on baseplates and mud sills or adequate firm foundation? Do all scaffolds uprights have baseplates?

  • Footings level, solid and able to support loads without settling?

  • All scaffold frames and uprights plumb and braced to prevent swaying and displacement?

  • All frames and panels braced by cross, horizontal, or diagonal braces which secure vertical members together laterally?

PLATFORMS

  • All platforms on working levels fully decked between uprights and guardrails?

  • Each platform a minimum 18" in width?

  • Front edge of platforms within 14" of face of work?

  • Is each platform hooked or cleated to the frame or extended at least 6" and not more than 12" past the frame?

  • Are overlapping walkboards occurring at a support and the overlap a minimum of 12"?

ACCESS

  • Scaffold more than 2' above or below point of access (ground or floor) have a ladder, stairway, integral prefabricated access frame or access from another scaffold or structure?

  • Are cross braces being used for access?

  • If yes, was this corrected?

  • Are walkthrough end frames being used?

  • If yes, was this corrected?

FALL PROTECTION

  • Employees more than 10' above lower level have fall protection?

  • Guardrail system secured in place?

  • Top rail between 38" - 45" high and capable of supporting 200lb with mid rails midway between top rail and platform?

  • Are toe boards, screens or barricades at heights above 10' in place if a hazard for falling objects exists?

SUPPORTING MULTI-LEVEL SCAFFOLD

  • Is the height of the scaffold greater than 4x the minimum base width?

  • If yes, is scaffold restrained from tipping by tying, guying or bracing?

  • Are horizontal ties no greater than 30' apart?

  • Are vertical ties at the 4:1 ration, then every 20' apart?

  • Are outriggers installed to increase the minimum base width?

INSPECTION

  • Was the scaffold inspected by a "Competent Person" at the beginning of the day or change in work shift?

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.