MONITORING CHECKLIST FOR WORKING AT HEIGHT

Checklist No :
Location :
Date :

S.No. Points Yes No NA

All the workers have been explained safe work

1
procedures.

An effective communication system have been

2
established and explained to the workers.

3 Adequate illumination (lighting) has been ensured.

4 Work area inspected prior to start of the job.

Area below the workplace is barricaded, especially

5
below hot works.

6 Arrangement for fastening hand tools made.

All work platforms are ensured to be of adequate

7
strength and ergonomically suitable.

ACCESS / EGRESS

Walkways provided with hand rail, mid rail and toe

1
guard.

Are ladders inspected and whether they are

2
maintained in good condition?

Are ladders properly secured to prevent slipping,

3
sliding or falling?

4 Metal ladders not used around electrical hazards.

5 Proper maintenance and storage.

6 Whether ladders placed at right slope.(1:4)

S.NO Points Yes No NA

7 Whether ladders, staircases anchored properly or not.

8 Are there any obstructions in the stairs?

Are landings provided with handrails, knee rails, toe

9
boards etc.?

10 Whether ramp is provided with proper slope?

11 Proper hand rail/guards provide in ramps.

PPE & SAFETY DEVICES

Use of safety helmets, safety harness, ensured for all

1
workers.

2 Are anchoring points available at all places of work?

Common life line provided wherever linear movement

3
at height is required.

4 Safety nets are in use wherever required.

Proper fall arrest system is deployed at critical work

5
places.

6 Safety systems for work on fragile roof are used.

Other Observations

Site Engineer: _____________________________

Verified by HSE Officer : _____________________________

Please note the file of filled in formats will be kept by HSE department