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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 />

No.<br />

Std<br />

Ref<br />

Questions to confirm compliance with the standard<br />

6.13 2 Have risk assessments been conducted?<br />

6.14 2 Are the required measures identified in the risk assessments implemented on site?<br />

6.15 2.1 Is there a written requirement th<strong>at</strong> in the design of new facilities and modific<strong>at</strong>ions to<br />

existing facilities all excav<strong>at</strong>ion, construction, oper<strong>at</strong>ing, modific<strong>at</strong>ion and<br />

maintenance activities for the foreseeable life of the asset are considered?<br />

6.16 2.1 Is there a written requirement th<strong>at</strong> in the design of new facilities and modific<strong>at</strong>ions to<br />

existing facilities, provisions to prevent falls are clearly identified in specific<strong>at</strong>ions?<br />

6.17 2.2 Where provisions to prevent falls were contained in purchasing specific<strong>at</strong>ions, and<br />

these provisions were changed, were changes made only with the consent of the<br />

origin<strong>at</strong>or of the specific<strong>at</strong>ion?<br />

6.18 3 Is carrying out a risk assessment for safe working <strong>at</strong> height part of the site competence<br />

program for persons who are to work where there is the risk of falling (and their<br />

supervisors)?<br />

6.19 3 Are all persons responsible for work carried out <strong>at</strong> height competent in the site<br />

management systems used for the prevention of falls?<br />

6.20 3 Are persons who will be required to work where they are exposed to a risk of falling<br />

(and their supervisors) able to particip<strong>at</strong>e in a risk assessment of the work?<br />

6.21 3 Are persons who will be required to work where they are exposed to a risk of falling<br />

(and their supervisors) familiar with the control measures for fall prevention?<br />

6.22 3 Are persons who will be required to work where they are exposed to a risk of falling<br />

(and their supervisors) competent in the correct use of control measures?<br />

6.23 3 Are competencies assessed and documented?<br />

6.24 3 Has competence been assessed and confirmed by a person qualified and authorised for<br />

the purpose and does their competence include training in workplace competence<br />

assessment?<br />

6.25 3.1 Is there an SWP procedure being followed which specifies the competency<br />

requirements for emergency services personnel to conduct a ‘rope rescue’?<br />

6.26 4.1 Are there procedures being followed which st<strong>at</strong>e the design, construction and disposal<br />

requirements for work pl<strong>at</strong>forms?<br />

6.27 4.1 Do persons who design, construct, and dispose of work pl<strong>at</strong>forms understand the<br />

requirements?<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 Team Leader<br />

Page 34 of 64

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