Title Page

  • Conducted on

  • Prepared by

Risk Assessment and control measures.

  • Has a risk assessment been done and approved?

  • Is a permit to work in place?

  • Have potential or existing hazards been identified and the risks assessed of anyone falling from heights?

  • Have alternative ways of carrying out the work been considered?

  • Have all practical steps been taken to prevent falls?

  • Is the ladder appropriate for the task or would another device such as a platform ladder/scaffold/elevated work platform be more appropriate?

  • Can three points of contact be maintained when using a ladder?

  • Are fall injury prevention systems required and in place?

  • Where anchor points are used to attach lanyards, are these approved?

  • Has it been assessed whether a fall will be arrested before hitting the ground /other structure?

  • Is there a risk of falling objects striking people below?

  • Is a rescue plan required and in place?

  • Are the weather conditions appropriate for the work being carried out?

  • Are the workers competent for the task?

  • Has fall prevention equipment been inspected?

Safe access and agrees.

  • Has the scaffold been tagged and inspected?

  • Are toe boards in place on the scaffolding?

  • Are walkways in good condition and free from obstructions?

Information , instruction and training.

  • Have employees been trained on working at heights?

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.