Working at Height Critical Control Checklist

• Site conducted

  Select

• Prepared by

• Conducted on

  Date

• Task Observed

• Workgroup Observed

• This Is A High Risk Activity: Unwanted Events: Fall from one level to another
  

• Has the hierarchy of controls been applied to the working at heights activities; e.g. eliminating the need to work at height where practicable, using fixed platforms such as scaffolding, edge protection, or EWP’s instead of fall arrest or restraint systems? S EWP’s have engineering controls to prevent crush injuries to operator (secondary guarding) unless risk assessment demonstrates not reasonably practicable.

  Yes

• Task specificJSEA developed, approved, responsibilities clear and applicable,JSEA available at work front and applicable workers have signed on

  Yes

• Working at height permit & rescue plan (where required) raised and approved, and available at the work front

  Yes

• Working at heights & supervision of working at heights performed by trained and competent workers

  Yes

• Harnesses and lanyards -Inspected prior to use by competent operators, details recorded on register

  Yes

• Harnesses and lanyards -Lanyards incorporate a shock absorber

  Yes

• Harnesses and lanyards -Fall arrest limits freefall to 1.8m

  Yes

• Harnesses and lanyards -Full body (5 point) harnesses used, attached to appropriately assessed anchor points

  Yes

• Equipment, Elevating Work Platforms & Scaffolding MUST be - Fit for purpose design and inspected/approved prior to use

  Yes

• Equipment, Elevating Work Platforms & Scaffolding MUST be - Compliant with the applicable Australian or equivalent standard

  Yes

• Equipment, Elevating Work Platforms & Scaffolding MUST be - Inspected by a competent person prior to use (Scaffold inspection tags)

  Yes

• Equipment, Elevating Work Platforms & Scaffolding MUST be - Used and maintained in accordance with manufacturer’s instructions, standards or design specifications

  Yes

• Equipment, Elevating Work Platforms & Scaffolding MUST be - Ongoing monitoring of work at heights controls and re-inspection/approval of changes as required

  Yes

• When conducting workers interview did the operators understand all controls required for working at heights and demonstrate competency in applying them

  Yes

• When conducting Visual Inspection - did activities occurring involving working at heights, or risk of fall are witnessed to have been safely planned, conducted, and supervised

  Yes

AUDITOR SIGNATURE

• Add signature

  Sign

AUDIT COMPLETION

• When audit has been completed please select yes to submit.

  Yes