Focus Worksite Verification Report

Date & Time: Company:

Locations:

Y/N
# 10. Scaffold Erection, Use and Inspection (N/A)
1 Are employees who erect and dismantle scaffolds qualified and competent?

2 Has a process been established to verify competency?

3 Are scaffolds free of defects and built per specifications?

4 Is documentation on file for scaffolding requiring engineered design?

5 Are scaffold decks secured?

6 Is complete decking provided?

7 Is decking free from debris, and materials stored correctly

8 Is all scaffolding provided with required access and egress? (max 30m apart)

9 Are all access openings equipped with swing gates

10 Are approved guardrails in place at least 950mm top, 470mm intermediate minimum
Are vertical scaffold standards used in conjunction with integral load dispersing devices (base
11 plates) at all times?
12 Is all scaffolding tied in suitably
Is there a process in place to ensure that scaffold components are not interchanged between
13 manufacturers / type?
14 Does all scaffolding have appropriate toe boards 225 mm
15 Are personnel accessing the scaffolds checking the tags?
16 Is fall protection worn when an employee is exposed to a fall hazard greater than 1.8m
17 Are scaffold tags used to identify incomplete scaffolds and stipulate requirements for safe use
of each scaffold?
18 Does the scaffold tag include the following information:
~ the date on which the scaffold was last inspected?
~ the duty rating of the scaffold?
~ the name of the competent worker who last inspected the scaffold?
~ any precautions to be taken while working on the scaffold?
19 Do scaffold inspection tags incorporate a three-color system? (Green, Yellow, Red) Take out
yellow
20 Are scaffold tags placed at the point of access and are clearly legible?

Page 1 of 2 REV 1 30-01-21

 Focus Worksite Verification Report
21 Has a competent person been assigned for inspecting all scaffolding upon erection?
22 Are scaffolds inspected at least every seven days?
23 Are the scaffold inspections logged formally?
24 Do all scaffolds have rest platforms installed and the ladder offset every 6 meters (20 feet)
were applicable
25 Do scaffold ladders extend at least 1 meter (3 rungs) above the uppermost working level of
the scaffold or have suitable hand holds installed
26 Do all scaffold ladders have hand rails fitted if applicable

Code Date
List of Deficiencies (see Person Responsible Sign as Complete
below) Completed

A = Immediate action B = 24 Hours C = 48 Hours D = One Week

Inspection Team
PRINT SIGNATURE

Page 2 of 2 REV 1 30-01-21