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Use this checklist to define safety measures before, during and after work shifts. Begin with a description of the work, take a photo of it and list down names of personnel doing the task. Next define the safety measures which include permits, proper training, safety routes, vicinities and equipment. Then check the harness if it is accurately connected and used. Afterwhich, Identify the changes that need to be executed and in the end, summarize the inspection by providing recommendations of equipment to be replaced or remove from service.
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Are all people on-site using the correct personal protective equipment?
Are people working on-site initiated on the safety procedures?
Are there systems for consultation with workers on safety, health and welfare matters?
Do workers have a protected way to their place of work?
Are employees suitably qualified in using a harness?
Are harnesses, lanyards and other safety gear checked and assessed?
Are safety tests administered before the use of the harness?
Are there first-aid facilities and do workers know where they are?
Are safety hats used in place for fall protection systems?
Are there any obstructions between the work area and the protection hat?
Is harness worn properly and attached to secure anchorage?
REFERENCE: Harness worn properly and added to secure anchorage[This is an instance of how you can use Lumiform to include best practice reference images in your templates to assist with examinations]
Do lanyards, anchorages, and lifelines support standard bodyweight?
Has the worker been charged a shock-absorbing lanyard for his own use?
Has the worker been assigned an approved travel restraint or lifeline rope for his own use?
Does the equipment function in accordance with the producer's recommendations?
Does the employee have his own rope grab?
Are locating device systems used so a worker on an elevated surface can have both hands free?
Are there any components in place that have been subjected to an impact been removed from service?
Are there no suggested change in the equipment used?
Do workers talk to the supervisor about health and safety matters and potential changes/training?
Full name and signature of the inspector:
Please note that this checklist template is a hypothetical example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.
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