JSA – Scaffolding – Andersons Scaffolding Services Pty Ltd

Step 1 of 5

This JSA is completed in conjunction with the Safe Work Method Statement (SWMS) for Erecting, Altering and Dismantling Scaffolding.

Acknowledgement of Risk Matrix*

I/we have read the Risk Assessment Matrix and understand it's content.

Client Name:*

Client Email (if they require a copy of this JSA)

Address*

Street Address

Date*

Job Owner:*

A toolbox talk at the start of each day should be completed to discuss any site specific safety information. Please list items toolboxed:*

Are there any hazards or risks specific to this site?*

What control measures will be put in place to minimise the risk of injury?*

With these control measures put in place, what is the risk of an injury occurring?*

Low (Proceed with work and monitor)

Moderate (Proceed with work and monitor)

High (Review and introduce more controls before starting work)

Major (Do not start work, further control measures are needed)

Control measures must be continuously monitored throughout the day to ensure they remain adequate. If an incident or injury occurrs, you must follow incident response procedures first, then control measures MUST be reviewed and amended accordingly to reduce the likelihood of the same or similar injury happening again.

Acknowledgement*

All employees/contractors have participated in the pre-start JSA and acknowledge and agree to abide by these control measures.

This risk assessment process has been developed in consultation and cooperation with employee/workers and relevant Employer/PCBU. I/we have participated in the above risk assessment and understand its contents. I/we confirm that I/we have the skills and training, including relevant certification to conduct the task as described. I/we agree to comply with safety requirements within this risk assessment including risk control measures, safe work instructions and Personal Protective Equipment described.

AS PART OF OUR COVID 19 SAFETY MEASURES, ONLY THE LEADING HAND/MOST EXPERIENCED SCAFFOLDER IS REQUIRED TO SIGN THIS JSA, AND ALL OTHER WORKERS PARTICIPATING IN THE PRESTART MEETING CAN BE LISTED AS HAVING ATTENDED.

Person conducting this Prestart meeting:*

Signature

Workers participating in the prestart:*

List the full names of all workers on site. To add another, click on the "+" button.

Job Safety Analysis

This JSA is completed in conjunction with the Safe Work Method Statement (SWMS) for Erecting, Altering and Dismantling Scaffolding.

AS PART OF OUR COVID 19 SAFETY MEASURES, ONLY THE LEADING HAND/MOST EXPERIENCED SCAFFOLDER IS REQUIRED TO SIGN THIS JSA, AND ALL OTHER WORKERS PARTICIPATING IN THE PRESTART MEETING CAN BE LISTED AS HAVING ATTENDED.

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