


(Type In Your Company Name Here)







Fall Protection Program


(Type in the Job Name Here)




Located at


(Type in the Job Site Address Here)


______________________


______________________


______________________


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Table of Contents

Fall Protection Program

Purpose	5

Anticipated Fall Hazards	5

Fall Prevention and Protection Measures	5

- Training	5

- Guardrail Systems	6

- Personal Fall Arrest and Restraint Systems	6

            - Covers	7




Purpose
The purpose of this program is to prevent worker 
injuries due to falls from elevations. It is the policy 
of (type in your company name) to make every 
reasonable measure to protect workers from job site 
fall hazards.  (Type in the name of your company's 
designated competent person) is the designated 
competent person assigned to oversee fall 
prevention and protection issues for (type in your 
company name) worker's at this job site.


Anticipated Fall Hazards
(Type in your company name) anticipates potential fall 
hazard from the following:

-	Use of mobile scaffolds;
-	Use of fixed scaffolds;
-	Use of scissors lifts;
-	Use of aerial lifts;
-	Floor openings; 
-	Wall openings
-	Use of straight ladders;
-	Use of extension ladders; and,
-	Use of step ladders.

Fall Prevention and 
Protection Measures
The following fall prevention or protection meas-
ures will be used by (type in your company name) 
employees whenever they are exposed to a potential 
fall of (use four feet for service work or six feet for 
construction work) or more to a lower level or object:


Mobile and Fixed Scaffolds:
Guardrail Systems and/or
Personal Fall Arrest Systems


Scissors Lifts:
Guardrail Systems and/or
Personal Fall Restraint Systems

Aerial Lifts:
Guardrail systems and 
Personal Fall Restraint Systems

Floor Holes:
Guardrail Systems or
Covers

Wall Openings:
Guardrail Systems or
Personal Fall Arrest Systems

Ladders: (6 foot and 4 foot height rule does not 
apply to ladders)
Before working on ladders such as straight ladders, 
extension ladders and stepladders workers will 
receive safety training that will cover:

-	Proper selection of ladders;
-	Proper ladder set-up;
-	How to safely secure ladders (where applicable);
-	How to safely ascend ladders;
-	How to work safely while on ladders; and,
-	How to safely descend ladders.


Training
All (type in your company name) employees will 
receive the applicable fall protection and/or 
prevention training prior to the start of work at the 
(type in the name of the facility/project).
All affected workers will receive classroom training 
that includes:

-	Awareness of the potential fall hazards that they 
are likely to encounter;
-	The specific measure or measures that will be 
used to prevent falls or protect them if they do 
fall;


-	How to properly use/implement these measures; 
and,
-	Where to find (type in name of your designated 
competent person) should any questions arise. 

In addition, all affected workers will receive 
"hands-on," task-specific fall prevention and/or 
protection training that applies to each identified 
potential fall hazard.

Guardrail Systems
When guardrails are used the following 
requirements will be met.

-	The top edge of guardrails will be (for construction 
work use between 39 inches and 45 inches. For service 
work use 42 inches) above the working surface.

-	(For construction work use Midrails. For service work 
use Intermediate rails) will be installed (for 
construction work use midway between the top edge of 
the guardrail. For service work use approximately 
halfway between the top rail) and the working 
surface).

-	(For construction use Guardrails will be capable of 
withstanding at least 200 pounds of force applied in any 
outward or downward direction at any point. For service 
work use Guardrails will be capable of withstanding at 
least 200 pounds of force applied in any direction at any 
point on the top rail). 

-	(For construction work use Midrails will be capable of 
withstanding at least 150 pounds of force in any outward 
or downward direction at any point. For service work 
delete this bullet).


Personal Fall Arrest and Restraint 
Systems
Where personal fall arrest systems are used for fall 
protection or fall restraint systems are used for fall 
prevention all affected employees and supervisors 
will observe the following measures.


-	All affected employees will use a full body 
harness. 

-	Only locking type snap hooks will be used.

-	Each affected employee will receive training on 
how to use the system properly.  The training 
will take place before work is started.

-	The competent person will periodically inspect 
all personal fall arrest or restraint systems.

-	Worn or damaged system parts will not be used.  
Such parts will be removed from service and 
disposed of immediately.

-	All system components must be compatible.

-	All affected employees will tie off to anchorage 
points that are identified or established by (type in 
the name of the designated competent person).

-	(Type in the name of the engineering company or 
construction firm) has confirmed that all anchorage 
points will support a minimum of 5,000 pounds 
of force.
Documentation is available in (type in the 
location of the documentation papers i.e. company 
job site trailer, etc.).

-	Deceleration devices will not be used with fall 
restraint systems.

-	Lanyards used for fall restraint will be long 
enough to allow the work to be performed, but 
short enough to prevent workers from falling.

-	All affected workers will follow the 
manufacturers' instruction that are specific to the 
lift being used with regard to the use of fall 
restraint systems on aerial lifts and scissors lifts.

-	All components of each personal fall arrest 
system will be stored in a job box when not in 
use.


Covers
When covers are used for fall prevention the 
following requirements will be met:

-	Where applicable, covers will be capable of 
supporting at least twice the maximum axle load 
of the largest vehicle that could require their 
support.

-	All covers will be capable of supporting at least 
twice the weight of workers, equipment and 
materials that could require their support.


-	All covers will be secured in place to prevent 
accidental displacement.

-	All covers will be clearly marked with the word 
"hole." The words will be large, legible and easy 
to see.

Any questions regarding these fall protection 
measures should be directed to (type in the name of the 
designated competent person).


