Professional Documents
Culture Documents
SELF-ASSESSMENT GUIDE
Instruction:
Read each of the questions in the left-hand column of the chart.
Place a check in the appropriate box opposite each question to indicate
your answer.
Can I? YES NO
Use personal protective equipment (PPE) in accordance with
Rule 1080 of Occupational Safety and Health Standards
Determine purpose of scaffolding with associated activities
Observe and follow site rules and regulations in erecting scaffold
according to safety and health practices*
Review, confirm and clarify work instruction and drawing
Identify, use and maintain scaffold erection hand tools
and secures to prevent fall*
Check and segregate tools and equipment in accordance
to industry practice
Identify scaffold components in accordance to industry practice
Understand types of supported scaffold and its capacity for
the necessary job requirement
Check, identify and report obstructions and hazards in the
job site*
Draw proposed sketches of modified scaffold in accordance
to site condition/project requirements *
Establish and maintain communication and coordination
with other workers in accordance with job requirement
Apply safety practices according to OSHS and other applicable
references
Observe scaffolding plan/ drawing in compliance with
work instruction
Secure perimeter with barriers and signage*
Prepare site and foundation in accordance with OSHS
requirements
1
CONSCA218-0719 ver. 1.00
Scaffolding Works NC II (Supported Type Scaffold)
Lay out plan as per design or manufacturer’s specification*
Prepare footings in accordance with OSHS requirements,
codes of practice, manufacturer specifications and engineer's
instructions*
Erect scaffold in accordance with OSHS and / or Department
Order (DO128-13) requirements and manufacturer specifications
or design by the structural engineer.*
Install fall protection devices in accordance with job specification
and OSHS requirements*
Visually inspect erected scaffold to check conformity using
checking tools and instruments in accordance with the
given
instruction/ plan. *
Identify and report faulty components to personnel in line
with company standard operating procedure
Report scaffolding instability to personnel in line with
company safe operating procedures
Dismantle scaffold using reverse procedure of erection by
lowering scaffold components in accordance to standard
work procedures*
Clean, check, maintain and store tools and equipment *
Move scaffolding components to specified location
following Occupational Safety and Health Standards
(OSHS) requirements and other applicable references*
Clear work area in accordance with company rules
and regulations
Store re-usable/ recyclable materials in accordance
with company rules and regulations
I agree to undertake assessment in the knowledge that information gathered will only
be used for professional development purposes and can only be accessed by
concerned assessment personnel and my manager/supervisor.
Evaluated by:
Qualified for Assessment
ENGR. STEVE Y. BANZON
AC Manager Not yet Qualified for Assessment
Date: