Professional Documents
Culture Documents
GO DIGITAL TODAY
Convert your paper
checklists into digital forms
Scan this QR code to use this
paper checklist on your
smartphone or tablet. Visit
www.iauditor.com
General Information
Type of scaffolding
Description of work
Enter text
Take a photo of it
Base
https://public-library.safetyculture.io/products/scaffolding-safety 1/11
23/10/2021, 16:51 Scaffolding Safety Checklist - SafetyCulture
Yes No N/A
Yes No N/A
Yes No N/A
Height
Are free-standing tower scaffold steadied with guy wire according to regulations
requirements for its height?
Yes No N/A
https://public-library.safetyculture.io/products/scaffolding-safety 2/11
23/10/2021, 16:51 Scaffolding Safety Checklist - SafetyCulture
Are safety cage needed around vertical ladder based on height according to regulatory
requirements?
Yes No N/A
Are perimeter placed on work surfaces (toe board permanent and temporary height)
according to regulatory requirements?
Yes No N/A
Are perimeter handrail height with a mid-rail around all work platforms according to
regulatory requirements?
Yes No N/A
Are rolling scaffold wheel brakes locked and outriggers extended to maintain maximum
height of 3 times the smallest base dimension?
Yes No N/A
Yes No N/A
https://public-library.safetyculture.io/products/scaffolding-safety 3/11
23/10/2021, 16:51 Scaffolding Safety Checklist - SafetyCulture
Are midrails installed approximately halfway between the toprail and the platform surface
Yes No N/A
Geometry
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
https://public-library.safetyculture.io/products/scaffolding-safety 4/11
23/10/2021, 16:51 Scaffolding Safety Checklist - SafetyCulture
Platforms
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Bracing
https://public-library.safetyculture.io/products/scaffolding-safety 5/11
23/10/2021, 16:51 Scaffolding Safety Checklist - SafetyCulture
Is the ledger bracing fitted on alternate pairs of standards for the full height of the
scaffold?
Yes No N/A
Yes No N/A
Is the façade bracing fixed to the face of the scaffold at standard intervals?
Yes No N/A
Yes No N/A
Yes No N/A
https://public-library.safetyculture.io/products/scaffolding-safety 6/11
23/10/2021, 16:51 Scaffolding Safety Checklist - SafetyCulture
Yes No N/A
Yes No N/A
Yes No N/A
Access
Yes No N/A
Yes No N/A
Yes No N/A
https://public-library.safetyculture.io/products/scaffolding-safety 7/11
23/10/2021, 16:51 Scaffolding Safety Checklist - SafetyCulture
Yes No N/A
Loading
Yes No N/A
Yes No N/A
Yes No N/A
Ties
Yes No N/A
https://public-library.safetyculture.io/products/scaffolding-safety 8/11
23/10/2021, 16:51 Scaffolding Safety Checklist - SafetyCulture
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Are toe boards fitted to all platforms and at least 150mm and secure?
Yes No N/A
Scaffolds Tag
https://public-library.safetyculture.io/products/scaffolding-safety 9/11
23/10/2021, 16:51 Scaffolding Safety Checklist - SafetyCulture
Yes No N/A
Yes No N/A
Have the inspections been written in and signed by the authorized person?
Yes No N/A
Yes No N/A
Recommendation
Overall Ranking
Pass Fail
https://public-library.safetyculture.io/products/scaffolding-safety 10/11
23/10/2021, 16:51 Scaffolding Safety Checklist - SafetyCulture
Enter text
Completion
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things,
workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to
determine if the use of such checklist is permissible in your workplace or jurisdiction.
https://public-library.safetyculture.io/products/scaffolding-safety 11/11