Copyright 2011 Elmbridge Borough Council

Date of assessment //..

Working at Height Assessment Checklist

Company Name: Task Description: Are there indications that the task is high risk? (Tick the appropriate boxes) Task has a history of accidents or incidents (e.g. accident book, RIDDOR reports). Task is known to be high risk. Questions to consider: Fragile materials: Are warning signs fixed at the approach to fragile roofs? Can fragile roofs/gutters be cleaned safely? Equipment: Are ladders, tower scaffolds etc used? Have workers been instructed in the safe use of ladders? Are ladders well maintained and inspected regularly? Are lift trucks used to gain access? Is the platform for use with a lift truck provided with guardrails; safety harness anchorage; protection from moving parts? Are there any tower scaffolds on site or hired in? Are guardrails and toe boards provided? Is the height of the tower scaffold no more than 3 times the minimum base dimension? Are harnesses used? Level of risk: (Tick as appropriate) Yes Low Med High Possible remedial action

cont

Copyright 2011 Elmbridge Borough Council

Questions to consider:

Level of risk: (Tick as appropriate) Yes Low Med High

Possible remedial action

Are anchorage points and supporting structures, lanyards and harnesses compatible, identifiable, regularly inspected? Contractors: Are contractors used? Are safety method statements required from contractors? Date by which action should be taken: Date for re-assessment: Assessors name: Signature: The above checklist may aid you in your risk assessment process. It is only an example and indicates some of the main points to be considered in an assessment when working at heights.

g:ehl/hsw/std letters.forms\Risk Assessment Working at Height