Title Page

  • Client / Site

  • Conducted on

  • Location
  • Prepared by

  • Nature of work

  • Other nature of work

Identification of Work at Heights Activities

  • Are there activities associated with working at heights?

  • Select activities

  • List other activities in the area involving working at heights

  • Are the employees / contractors / members of public at risk from work at height identified?

  • List their names here

  • Frequency of performing these activities

Identification of Hazards

  • Employee falling from height

  • Employee falling through a fragile roof

  • Objects falling on employees / members of the public

  • Slipping / collapsing access equipment

  • Slips / trips on elevated access ways

Control Measures

PLANNING

  • Is working at heights avoided where possible?

  • Is work at heights properly planned and organised?

  • Has the work area been surveyed for hazards, eg overhead power lines, unsuitable ground conditions, moving machinery parts?

  • During work at height is there always a competent person present who can suspend work if conditions change, eg weather, traffic, scope of work?

FRAGILE ROOFS

  • Are fragile roofs identified, labelled especially where fragility is disguised?

  • Are warning signs fixed on the approach to fragile roofs?

  • Is unauthorized access to roofs / roof spaces prevented?

LADDERS/ACCESS EQUIPMENT

  • Are portable ladders, steps and all other access equipment regularly inspected?

  • Are ladders only used for light work of short duration?

  • Are work platforms with edge protection, such as tower scaffolds, cherry pickers, scaffolding always used?

  • Are work platforms sufficiently wide to walk on without risk of stumbling or losing balance?

  • Are work platforms capable of supporting workers, equipment, materials, the safe working loads indicated and inspected every six months?

  • Is there a log maintained for ensuring quality of these equipment?

OPEN EDGES

  • Are open vertical drops identified and properly guarded when open?

  • Are hand rails present on the open side of staircases?

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

  • Is fixed edge protection provided to prevent falls where working at heights cannot be avoided?

  • REFERENCE: Edge protection installed properly
    [This is an example of how you can use iAuditor to include best practice reference images in your templates to assist with inspections]

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RACKING

  • Is storage properly planned which discourages climbing racking or pallets to access goods?

  • Are adequate provisions in place to allow safe access to stored / displayed goods?

  • Are staff trained in safe working methods to access high level racking?

TRAINING

  • Have all workers who work at heights been assessed as competent or closely supervised by someone who is competent?

CONTRACTORS

  • Do contractors provide safe written working procedures for work at heights, are they screened / instructed and is their work monitored by a competent person?

PROTECTIVE EQUIPMENT

  • Where the risk of falls cannot be eliminated are safety harnesses, fall arrest devices or safety nets used as required?

  • Are anchorage points for safety harnesses and ladders provided, used and regularly inspected?

  • Write down positive observations

Recommendations

  • List recommendations here

Completion

  • Full Name and Signature of Inspector

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.