RISK ASSESSMENT RECORDING FORM

Location or
Address: 30 the ge!e" M# !edroo$ %a
Date Assess$ent
&nderta'en: ()*+(*+3
Assess$ent ,nderta'en
-#: Natasha
Acti.it# or
Sit,ation Ca/t,ring /hoto0s
Re.ie%
Date: n*a
Signat,re
1+2 3a4ard Ris' 1(2 5ho $ight !e har$ed and ho%6 132 5hat contros e7ist to red,ce
ris'
182 5hat action can !e ta'en
to 9,rther red,ce ris'6
Burning yourself on the radiator
The door hitting you when opened
Getting trapped in the room
1-4
1-4
1-5
Anyone near the radiator
Anyone behind the door
Anyone in the room
Risk rating 4. Turn the radiator to a
ooler degree
Risk rating 5. !arn e"eryone not to
enter the room
Risk rating #. $ea"e the door slightly
open
Turn the radiator off
%ake sure they follow your rules.
&pen the door ompletely
RISK RATING
a SE:ERIT; ! LIKELI3OOD c FINAL SCORE RATING: %hat needs to !e done
< D#ing or !eing /er$anent# disa!ed < 5i a$ost certain# ha//en +=>(< Sto/? Do not start acti.it# again ,nti ris' is
controed
8 Serio,s in@,r#*ong ter$ iness 8 3igh# i'e# to ha//en +0>+< 3igh ris' e.e" 3igh /riorit#A Ta'e action
straight a%a# to contro the ris'
3 Te$/orar# disa!iit#*3 da#s o99 sic' 3 Not so i'e# =>B Medi,$ ris' e.eA Tighten ,/ contros and
$a'e a /an to do so$ething a!o,t ris'
( 5i need $edica attention ( E.en ess i'e# 3>< Fair# o% ris' e.eA Lo% /riorit# !,t 'ee/
/ossi!e action in $ind
+ Minor in@,r# egA -r,ise" gra4e + &ni'e# to ha//en at a +>( Lo% or tri.ia ris'A No 9,rther action
reC,iredA
SO: a 7 ! D c
Action ReC,ired Res/onsi!e Eerson Date 9or Co$/etion