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Scaffolding Safety Checklist
Scaffolding Safety Checklist
Inspection Date & Time
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AM/PM
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Company Name
Job Site Name (if applicable)
Scaffold Location
Supervisor Name
First Name
Last Name
General Rules
Has the scaffold been inspected before each use?
Yes
No
If No, explain what will be done to rectify the issue
No more than inch gaps between scaffold planks
Yes
No
If No, explain what will be done to rectify the issue
18 inches width for platform (no more than 12 inches on pump jacks)
Yes
No
If No, explain what will be done to rectify the issue
Can scaffold support at least four times its intended load?
Yes
No
If No, explain what will be done to rectify the issue
If work height is more than 10 feet, is there a guardrail system?
Yes
No
If No, explain what will be done to rectify the issue
Check all that apply for guardrail:
Toprail
Midrail
Toeboard
Posts
Do the planks extend less than 12 inches past the ends of the scaffold?
Yes
No
If No, explain what will be done to rectify the issue
Are the wheels and casters locked while in use?
Yes
No
If No, explain what will be done to rectify the issue
Is the work platform free from clutter?
Yes
No
If No, explain what will be done to rectify the issue
Is there a ladder present or other safe way to get on and off the scaffold?
Yes
No
If No, explain what will be done to rectify the issue
Is the scaffold height greater than three times its base width?
Yes
No
If No, explain what will be done to rectify the issue
Is there appropriate protection against falling materials if there are workers below the scaffold?
Yes
No
If No, explain what will be done to rectify the issue
Is there a minimum power line clearance of 10 feet?
Yes
No
If No, explain what will be done to rectify the issue
Is each scaffold platform and walkway at least 18 inches (46 cm) wide?
Yes
No
If No, explain what will be done to rectify the issue
Is ladder jack scaffold, top plate bracket scaffold, roof bracket scaffold, or pump jack scaffold at least 12 inches (30 cm) wide?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Is the lumber free of cracks, splits, and knots?
Yes
No
N/A
If No, explain what will be done to rectify the issue
If the scaffold is defective, has it been tagged out and removed from service?
Yes
No
If No, explain what will be done to rectify the issue
Are front-end loaders and similar pieces of equipment being used to support scaffold platforms?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Are fork-lifts being used to support scaffold platforms? This is acceptable as long as the entire platform is attached to the fork and the fork-lift is not moved horizontally while the platform is occupied.
Yes
No
N/A
If No, explain what will be done to rectify the issue
Suspension Scaffolds
Is the height to base width ratio less than 4:1?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Are base plates used on scaffold frames and uprights?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Are suspension scaffold outrigger beams made of structural metal or equivalent strength material, and restrained to prevent movement?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Is the scaffolding base level and rigid with no settling?
Yes
No
If No, explain what will be done to rectify the issue
Are the inboard ends of suspension scaffold outrigger beams stabilized by bolts or other direct connections to the floor or roof deck, or have their inboard ends stabilized by counterweights? Please note that Masons’ multi-point adjustable suspension scaffold outrigger beams shall not be stabilized by counterweights.
Yes
No
N/A
If No, explain what will be done to rectify the issue
Are counterweights made of non-flowable material?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Are counterweights secured by mechanical means to the outrigger beams to prevent accidental displacement?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Are outrigger beams (not stabilized by bolts or other direct connections to the floor or roof deck) secured by tiebacks?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Is the shackle or clevis with which the rope is attached to the outrigger beam placed directly over the center line of the stirrup?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Are suspension scaffold support devices (cornice hooks, roof hooks, roof irons, parapet clamps) made of steel, wrought iron, or materials of equivalent strength?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Have ropes been inspected for defects by a competent person prior to each work shift and after every occurrence which could affect a rope's integrity?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Scaffold Access
If platforms more than 2 feet (0.6 m) above or below a point of access, are ladders, ramps, walkways, access from another scaffold, personnel hoist being used?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Are hook-on and attachable ladders positioned so that their bottom rung is not more than 24 inches (61 cm) above the scaffold supporting?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Are the ladders minimum rung length 11 1/2 inches (29 cm)?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Is the rung maximum spacing on the hook-on and attachable ladders 16 ¾ inches?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Is the bottom step not more than 24 inches (61 cm) above the scaffold supporting level?
Yes
No
N/A
If No, explain what will be done to rectify the issue
Signature & Date
Date/Time
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AM/PM
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Signature
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