Self Assessment Questionnaire Safe Working at Height ... - MIRMgate
Self Assessment Questionnaire Safe Working at Height ... - MIRMgate
Self Assessment Questionnaire Safe Working at Height ... - MIRMgate
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Major Hazard Audit Protocol<br />
<strong>Safe</strong> <strong>Working</strong> <strong>at</strong> <strong>Height</strong>s – <strong>Self</strong> <strong>Assessment</strong> <strong>Questionnaire</strong><br />
** Uncontrolled copy. Printed 5/10/04 **<br />
4.5 Maintenance Manager<br />
No.<br />
Std<br />
Ref<br />
Questions to confirm compliance with the standard<br />
5.1 1 Does the site have a written policy and procedures for working <strong>at</strong> height th<strong>at</strong> includes<br />
the responsibilities for the requirement th<strong>at</strong> risk assessments are conducted only by<br />
competent personnel?<br />
5.2 1 Does the site have a written policy and procedures for working <strong>at</strong> height th<strong>at</strong> includes<br />
the responsibilities for selection of appropri<strong>at</strong>e control measures by the hierarchy of<br />
controls?<br />
5.3 1 Does the site have a written policy and procedures for working <strong>at</strong> height th<strong>at</strong> includes<br />
the responsibilities for compliance with all applicable current st<strong>at</strong>utory and regul<strong>at</strong>ory<br />
requirements<br />
5.4 1 Does the site have a written policy and procedures for working <strong>at</strong> height th<strong>at</strong> includes<br />
the responsibilities for ensuring personnel are not exposed to hazards arising from<br />
working <strong>at</strong> height?<br />
5.5 1 Do the persons responsible understand their responsibilities?<br />
5.6 2 Is there a written procedure being followed th<strong>at</strong> st<strong>at</strong>es the site requirements to ensure<br />
work is not undertaken, where there is the risk of falling, without adequ<strong>at</strong>e fall<br />
prevention measures in place?<br />
5.7 2 Does the written procedure include measures to ensure th<strong>at</strong> where practicable, the<br />
need to work where there is the risk of a fall is elimin<strong>at</strong>ed?<br />
5.8 2 Does the written procedure include measures to ensure th<strong>at</strong> risk assessments are<br />
conducted before the commencement of work and <strong>at</strong> any time the scope of work<br />
changes or the risk of a fall increases?<br />
5.9 2 Does the written procedure include measures to ensure th<strong>at</strong> appropri<strong>at</strong>e measures are<br />
selected using the hierarchy of controls (Elimin<strong>at</strong>ion, substitution, redesign,<br />
separ<strong>at</strong>ion, administr<strong>at</strong>ive and personnel protective equipment) ?<br />
5.10 2 Does the written procedure include measures to ensure th<strong>at</strong> all equipment used is fitfor-purpose?<br />
5.11 2 Does the written procedure include measures to ensure th<strong>at</strong> <strong>at</strong> shift changes, incoming<br />
personnel are aware of the measures being used for work in progress?<br />
5.12 2 Do personnel who are responsible for conducting work <strong>at</strong> height understand the<br />
required measures?<br />
NA YES NO Documents th<strong>at</strong> you should be able to<br />
access and actions required<br />
Comments<br />
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00<br />
Maintenance Manager<br />
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