Record of necessary action

1. Will you be working at height? (see definition)

Definition of ‘working at height’

Any work activity where an injury could result from a fall from any height. For example:

a) using a chair or other furniture to gain access to stored items;

b) using a ladder, steps or similar portable equipment to gain access to areas of storage or for intended work activity;

c) using purpose-built, non-portable equipment to gain access to areas of storage or for intended work activity; and

d) any other working at height not covered by a) – c) above.

If ‘No’, you need only refer to your other risk assessments, as you have defined the work activity is not at height. If ‘Yes’, describe below the workplace details.

Workplace Details:

Location:______________________________________________________

Foreseeable Specified Risk(s): (a, b, c and/or d above)__________________

Description of Task: ________________________________________________

__________________________________________________________________________________________________________________________________

If ‘No’, you need to define how the work will be completed without working at height.

If ‘Yes’, continue below.

Yes No

3. Will employees or contractors or a mixture of the two complete the work at height?

(See Note below)

Note: Regardless of who completes the task, a safe working procedure must be written, fully discussed with and understood by those who will undertake the task before any work commences.

Fill in this section if the only option to complete the

task is to work at height (see section 1 for definition).

4. Fall Prevention and Injury Minimisation

Yes

No

a). In line with the specified risks in 1 above, have you identified work equipment or other measures to prevent falls?

If ‘Yes’ complete Section b) only.

If ‘No’ complete Sections b) and c)

b). Have you considered how collective protection measures (e.g. guard rails) should be used in preference to personal protection measures (e.g. harnesses) and specified these in a written safe system of work?

In particular, have you specified:

1. How the work will be completed, by whom and under whose control?

2. The arrangements to account for weather conditions, if applicable?

3. The checks needed to ensure only competent people do the work?

4. The measures to ensure that the place of work, including the means of access, will be safe at all times?

5. The inspection requirements for the equipment being used, including its positioning and security, before any work begins?

6. The measures needed to prevent objects falling?

7. The controls needed concerning fragile surfaces?

c). Have you considered how to minimise the distance and consequences of a fall should one occur? In particular:

1. Has the work been planned and organised by a competent person?

2. Are those involved in working at height fully aware of the risks, properly trained in all aspects (including fall arrest systems) and competent to do the work?

3. Is the work to be completed within the scope of a suitable permit-to-work system and has/will a permit been issued for this task?

4. Is the work equipment, including any fall arrest systems and communication arrangements, fully specified in writing?

5. Is there evidence that the work equipment, including any attachment devices for fall arrest equipment, has been properly maintained and inspected by a competent person?

6. Have suitable arrangements been made to rescue/retrieve any person whose fall has been arrested (by a harness, catch net, inflated cushion, etc.)?

7. Have suitable people been identified and trained to monitor the working at height activities?