Work at height

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

Work Planning and Risk Management

• Has risk assessment (RA) been conducted and are safe work procedures (SWP) developed for the<br>works?

  Yes

  No

  N/A

• Are the hazards and risk control measures communicated to all workers?

  Yes

  No

  N/A

Processes and Procedures

• Is there adequate supervision to ensure that safe work practices for working at heights are in place?

  Yes

  No

  N/A

• Have all workers received the necessary instruction, information and training for them to perform work at heights

  Yes

  No

  N/A

General Requirements

• Every open side or opening into or through which a person may fall is covered or guarded by an effective barrier to prevent falls.

  Yes

  No

  N/A

• Where covers are used for openings, are these covers securely fixed to prevent accidental displacement?

  Yes

  No

  N/A

• Where any work at height is to be carried out, is safe means of access to and egress provided?

  Yes

  No

  N/A

• Are measures always taken to prevent falling objects injuring others as a result of working at heights?

  Yes

  No

  N/A

• Every open side of a staircase is provided with a substantial handrail and lower rail or other effective<br>means and maintained.

  Yes

  No

  N/A

• Where the risk of falls cannot be eliminated are safety harnesses, fall arrest devices as required? <br>

  Yes

  No

  N/A

PROTECTIVE EQUIPMENT

• Are workers instructed on the proper method to wear and use the safety harness or restraint belt, as well as attach it to the lifeline or anchorage point?

  Yes

  No

  N/A

• Is PPE being properly used and maintained?

  Yes

  No

  N/A

• Is sufficient and secured anchorage provided?

  Yes

  No

  N/A

• Is the anchorage point or lifeline being used by the workers who are working at height?

  Yes

  No

  N/A

SCAFFOLD

• Has the scaffold been setup according to manufacturer’s instructions?

  Yes

  No

  N/A

• All scaffold components in place and no defects?

  Yes

  No

  N/A

• Scaffold control tag has been signed and approved for use?

  Yes

  No

  N/A

• Scaffold secured to structure to prevent movement?

  Yes

  No

  N/A

• Guard railing in place on all open sides and ends?

  Yes

  No

  N/A

• Proper access to get on and off the scaffold? Ladder secured in place?

  Yes

  No

  N/A

LADDERS

• If ladders are being used, are they being used correctly?

  Yes

  No

  N/A

• Is every ladder and step-ladder used of good construction, sound material and adequate strength for the purpose for which it is used?

  Yes

  No

  N/A

• Where a ladder is used for access or as a working place, are adequate handholds provided to a height of at least one metre above the place of landing of the highest rung to be reached by the feet of any person on the ladder?

  Yes

  No

  N/A

• Is the ladder or step-ladder secured so as to prevent undue swaying or displacement?

  Yes

  No

  N/A