Step Ladder Safety Assessment Form
Use this form to inspect and record the safety condition of a step ladder before, during, or after use.
Ladder Identification
Ladder ID or Asset Tag
*
Location of Use or Storage
*
Ladder Type
*
Step Ladder
Platform Step Ladder
Folding Step Ladder
Other
Manufacturer or Brand
Model
Ladder Material
*
Aluminum
Fiberglass
Wood
Other
Inspection Details
Inspection date
*
 -
Month
 -
Day
Year
Date
Inspector name
*
Department / team
Inspection purpose / status
*
Please Select
Routine inspection
Pre-use check
Post-incident inspection
Corrective follow-up
General Condition Assessment
General condition assessment
*
Rows
Excellent
Good
Fair
Poor
Unsafe
Overall structural condition
1
2
3
4
5
Cleanliness
6
7
8
9
10
Corrosion or damage
11
12
13
14
15
Label readability
16
17
18
19
20
Stability
21
22
23
24
25
Usability
26
27
28
29
30
Overall condition rating
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Overall status
*
Pass
Pass with notes
Fail
Remove from service
Step and Platform Condition
Step and Platform Condition
*
Rows
Compliant
Non-Compliant
Comments
Steps clean and dry
31
32
Steps free of cracks or bends
33
34
Steps free of oil or grease
35
36
Anti-slip tread intact
37
38
Platform secure
39
40
Hinges secure
41
42
Spreader bars function correctly
43
44
Steps clean and dry
Yes
No
Compliant
Non-Compliant
Steps free of cracks or bends
Yes
No
Compliant
Non-Compliant
Anti-slip tread intact
Yes
No
Compliant
Non-Compliant
Platform secure
Yes
No
Compliant
Non-Compliant
Additional comments on step and platform condition
Feet, Locks, and Hardware
Feet / non-slip caps present and intact
*
Yes
No
Not Applicable
Locking mechanism works properly
*
Yes
No
Not Applicable
Hinges secure
*
Yes
No
Not Applicable
Rivets / bolts present and tight
*
Yes
No
Not Applicable
Rails straight and undamaged
*
Yes
No
Not Applicable
Observed defects
Usage and Work Conditions
Typical task performed from this ladder
*
Surface used on
*
Concrete
Tile
Wood
Carpet
Outdoor ground
Other
Environment
*
Indoor
Outdoor
Both
Used within intended duty rating and height limits
*
Yes
No
Not sure
Inspection Findings and Corrective Action
Hazards Observed
*
Immediate Action Taken
*
None
Cleaned/Dried
Tagged Out
Repaired
Removed from Service
Other
Corrective Action Required
*
Target Completion Date
*
 -
Month
 -
Day
Year
Date
Submit Assessment
Should be Empty: