The Level 1 Assessment Checklist is designed to evaluate an operative’s competency in safely working at height using a ladder, full body harness, and cow’s tail lanyard system. This checklist covers critical steps such as the inspection and correct use of PPE and equipment, proper ladder positioning and securing, and adherence to safe climbing and work practices. The checklist ensures that the operative follows the established safety protocols, maintains fall protection throughout the task, and demonstrates a thorough understanding of the procedures involved in the Level 1 ladder access system.
Learner’s Name: _____________________
Date: _______________________________
Assessor’s Name: _____________________
Pre-Work Preparation:
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Personal Protective Equipment (PPE) Application
- ☐ Gloves, safety helmet, and safety boots worn before starting any task
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Selection of Equipment
- ☐ Drill and eye bolt anchor selected and in working order
- ☐ Ratchet strap available and free of defects
- ☐ Ladder suitable for the task (correct height, condition, and stability)
- ☐ Full body harness selected and checked for defects
- ☐ Cow’s tail lanyard selected and inspected
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Visual Inspection of Equipment
- ☐ Brief visual inspection performed on all equipment
- ☐ No visible defects identified in PPE, harness, lanyard, or other equipment
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Risk Assessment
- ☐ Task-specific risk assessment completed
- ☐ Method of access (ladder with harness) deemed suitable for the task
Installation and Set-Up:
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Anchor Installation
- ☐ Drill hole made in correct location (1.5–1.8 meters above ground)
- ☐ Eye bolt anchor inserted and tightened securely
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Ladder Positioning
- ☐ Ladder positioned at the correct angle (1 out for every 4 up)
- ☐ Standoff bracket or ladder leveling device used if necessary
- ☐ Ladder stably erected against the wall
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Ladder Securing
- ☐ Ratchet strap passed through ladder rung and eye bolt
- ☐ Ladder secured firmly without over-tightening
PPE and Climbing Preparation:
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Full Body Harness Application
- ☐ Full body harness properly worn with all straps tightened and clips secured
- ☐ Cow’s tail lanyard attached to the front of the harness with carabiner stowed safely
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Final Pre-Climb Checks
- ☐ Final visual check of all equipment and connections before climbing
- ☐ Lanyard clipped securely before ascent
Climbing and Working at Height:
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Ladder Climbing Technique
- ☐ Ladder climbed safely and steadily, with three points of contact maintained
- ☐ Cow’s tail lanyard disengaged at the work position and clipped onto the highest reachable rung
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Work Position Stability
- ☐ Lanyard clipped securely in front at work position allowing both hands free for work
- ☐ Body remains stable throughout the work activity
Descent and Task Completion:
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Descent Preparation
- ☐ Tools and equipment either secured in a tool belt or lowered safely to the ground
- ☐ Cow’s tail lanyard disengaged and re-clipped to harness before descent
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Ladder Descent
- ☐ Ladder descended in a controlled and safe manner
Post-Work Procedures:
- Equipment Check and Task Conclusion
- ☐ Visual inspection of all equipment after use to check for wear or damage
- ☐ Ladder and other equipment disassembled and stored properly
Final Assessment:
- ☐ Learner demonstrated competent use of the ladder, harness, and cow’s tail lanyard system.
- ☐ Learner adhered to all safety protocols and demonstrated good practices in PPE use.
- ☐ Learner completed the task safely and efficiently.
Comments/Feedback:
Final Result: Assessor’s Signature: _____________________
☐ Competent
☐ Not Yet Competent
Date: _______________________________
