Scaffold inspection checklist with the four triggers

The form itself

A static copy of the finished form, exactly as it renders. Nothing here can be filled in or submitted, so read it as a reference and build your own from the button above.

Every field, and what it collects

The complete field list, in the order respondents meet it.

Scaffold

Scaffold locationShort textRequired

Scaffold typeSingle choiceRequired

Options: Tube and coupler · Modular · Mobile tower

Reason for this inspectionSingle choiceRequired

Options: Before first use · After an alteration or repair · After an event such as a storm or impact · Routine, 30 days since the last inspection

Structure

Structure checksRating gridRequired

Statements:

• Base plates and sole boards
• Standards plumb
• Ledgers and transoms
• Bracing complete
• Ties at the right spacing
• Planks or decks secured
• Toe boards

Edges and access

Edge protectionRating gridRequired

Statements:

• Guardrails
• Mid rails
• Access ladder or stair
• Containment screens or mesh

Scaffold tag updated?Single choiceRequired

Options: Yes, safe to use · Yes, unsafe, do not use

Photos of the scaffoldFile upload

Up to six photos. One of each elevation and one of anything that failed.

Inspector scaffolding licence numberShort textRequired

InspectorSignatureRequired

What each field on this form collects

The location is free text so it can name an elevation and grid lines, then the scaffold type and the reason for the inspection are single choices. The structure grid has seven rows: base plates and sole boards, standards plumb, ledgers and transoms, bracing, ties, decks secured and toe boards. The edge protection grid has four: guardrails, mid rails, access ladder or stair, and containment screens. A single choice records what the tag now says. A file upload takes up to six images, a short text holds the inspector's licence number, and the inspector signs.

The four triggers for a scaffold inspection

Under the model WHS Regulations, a scaffold from which a person or object could fall four metres or more must be inspected by a competent person before first use, after repair or alteration, after an event likely to affect its stability, and at least every 30 days. The reason question lists those four triggers word for word, so every record shows which one applied. A storm, a truck clipping a standard or a tie removed by another trade are the events that matter. WorkSafe Victoria's scaffolding pages and its alerts on scaffold collapses and falls from incomplete scaffolds make the same point from the other side.

The scaffold tag

The tag at each access point is what workers read before climbing. It says whether the scaffold is safe to use, who inspected it and when. The form does not replace the tag; it asks whether the tag was updated and what it now says, so the paper record at the access point and the digital record agree. When the answer is unsafe, the thank you screen tells the inspector to barricade the access point until the scaffolder fixes the fault and a new inspection passes.

How to adapt this form

A painting contractor working from mobile towers drops ties and containment screens and adds rows for castor locks and outriggers. A scaffold hire company adds the hand over certificate number and the client's site contact. A builder with several scaffolds on one job adds a dropdown of scaffold numbers so the responses table can be filtered per scaffold.

What makes this form work

Questions people ask

Other form examples