Work at Height Inspection

• Audit Title

• Site

• Conducted on

  Date

• Prepared by

• Position

• Location
  Address

• Personnel

1.0 - Work at height

• 1.1 - Is all scaffolding erected, altered or dismantled by competent persons (CISRS)?

  Yes

  No

  N/A

• 1.2 - Are scaffolders adhering to the NASC SG4:10 guidance notes?

  Yes

  No

  N/A

• 1.3 - Has a safe access/egress been provided?

  Yes

  No

  N/A

• 1.4 - Are suitable precautions being taken to prevent persons falling from working at height?

  Yes

  No

  N/A

• 1.5 - Are adequate precautions in place to prevent falling materials?

  Yes

  No

  N/A

• 1.6 - Are persons trained in the operation of equipment?

  Yes

  No

  N/A

• 1.7 - Have safety nets been erected by competent persons, where appropriate?

  Yes

  No

  N/A

• 1.8 - Has an emergency rescue plan been prepared and communicated?

  Yes

  No

  N/A

• 1.9 - Are statutory tests/examinations available and up to date?

  Yes

  No

  N/A

• 2.0 - Has a Scafftag been clearly displayed and completed on each scaffold entry point?

  Yes

  No

  N/A

• 2.1 - Are all working platforms inspected by a competent person in accordance with statutory requirements?

  Yes

  No

  N/A

• 2.2 - Have all ladders been uniquely numbered and fitted with a ladder tag?

  Yes

  No

  N/A

• 2.3 - Are working platforms clear of debris / trip hazards?

  Yes

  No

  N/A

• 2.4 - Are all handrails at least 950mm from the working platform, fitted with an intermediate rail with gaps no greater than 450mm?

  Yes

  No

  N/A

• 2.5 - Are toe boards fitted (minimum height 150mm)?

  Yes

  No

  N/A

• 2.6 - Do all ladders project 1m above the working platform?

  Yes

  No

  N/A

• 2.7 - Where MEWPs being used are they used in compliance with manufacturers operating procedures and inspected, examined and tested to comply with legislation with records kept.

  Yes

  No

  N/A

• Name of person producing report

  Sign

• Name of person receiving report

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