LOCATION RISK ASSESSMENT FORM

PRODUCTION TITLE: St Theresas Childrens Project PRODUCTION OFFICE PHONE/MOBILE: 07896815557

SHOOT DATE/S: 21/03/2013

LOCATION THIS FORM RELATES TO: Church Farm, Church Road, Norwich Complete the following table rating each risks severity on scale from Negligible (N), Low risk (L), Moderate risk (M), Severe (S), Very severe (V) each risks likelihood on scale from Very unlikely (VU), Unlikely (U), Possible (P), Likely (L), Very likely (VL) Determine the risk factor from the table below. Hazard 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Alcohol/drugs Animals/insects Audiences Camera cable/grip equipment Confined spaces Derelict buildings/dangerous structures Electricity/gas (other than normal supplies) Fatigue/long hours Fire/flammable materials Hazardous substances Heat/Cold/extreme weather Laser/strobe effects Machinery/industrial/ crane/hoist Materials - glass, non-fire retardant set materials Night operation Noise high sound levels Non standard manual handling Public/crowds Radiation Scaffold/Rostra Smoking on set Special effects/explosives Special needs (elderly, disabled, inexperienced) Specialised rescue/first aid Stunts, dangerous activities Tall scenery/suspended ceilings Vehicles/speed Water/proximity to water Weapons Working at heights Working overseas Other risks Present? N Y N N N N N Y N N N N N N Y N N N N N N N N N N N N N N N N N M VL 2 L P 2 L U 2 Severity Likelihood Risk Factor

Calculate the Risk Factor:

Very severe Severe Moderate Slight Negligible Very Unlikely 3 2 2 1 1 Unlikely 4 3 2 2 1 Possible 4 3 3 2 2 Likely 5 3 3 3 2 Very Likely 5 5 3 3 3

Decide the action to take: 5 Very severe 4 Severe 3 Moderate Risk 2 Low Risk 1 Negligible

Take immediate action High priority Programme for action Action may be required Probably acceptable

Then list each risk identified

Hazard no: Description Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take

2 Risk Factor (1-5) 2 Animals/insects. There may be a cat in the room whilst filming is taking place, which could move the camera. C Keep the cat out of the room whilst filming is happening.

Person/company responsible Roisin Crook for action To be completed at agreed later date Exposed person(s) Y Agreed action taken? (y/n) informed? (y/n)

Risk removed? (y/n)

Hazard no: Description Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take

8 Risk Factor (1-5) 2 Fatigue/long hours. This may be a problem as it is late in the evening to film. This is because both Teresa and Will work during the day. C Stop filming if they become too tired and re-schedule for another day.

Person/company responsible Teresa Norton and Will Alderton for action To be completed at agreed later date Exposed person(s) Y Agreed action taken? (y/n) informed? (y/n) Hazard no: Description Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take

Risk removed? (y/n)

15 Risk Factor (1-5) 2 Night operation. This is because both Teresa and Will work during the day. C Stop filming if they become too tired or it becomes too dark inside and re-schedule for another day.

Person/company responsible Roisin Crook for action To be completed at agreed later date Exposed person(s) Y Agreed action taken? (y/n) Y Risk removed? (y/n) Y informed? (y/n) Copy and paste this table for each of the hazards, then get the form signed. If the producer has not completed the risk assessment, then they should countersign this form. Completed by: Roisin Crook Signature Position: Producer/ director Date: 21/03/2013

Countersigned by: Signature

PRODUCER Date: