Establishment/Department

Establishment Risk
Assessment Form

RA01

Name and Address of Establishment

Person(s)/Group at Risk

Initial Assessment
Review
Following Incident

Students
Activity/Task/Process/Equipment

Date of Assessment
Assessor(s)
7-2-2016

Guitar and ukulele lessons

Are any additional

measures or actions
required? (if yes put on
the Action Plan)
Yes
No

Significant Hazard and

possible
Outcomes/injuries

Control Measures in Place

Trippind from trailing

electric guitar cables

Run them out of the way as much as possible.

none

Bendind to read
music can cause long term
back injury

Have music a reasonable height

none

Music stands can

cause injury

Do not use them

none

Page 3 of 3

Page 4 of 3

Assessors Recommendations - Additional Control Measures or Actions

Date action
to be
carried out

List Actions / Additional Control Measures

Person
Responsible

Date action
completed

Signed: the Headteacher/Head of Department: .........................................................

Date...........................................

The outcome of this assessment should be shared with the relevant staff
A copy of the completed assessment to be kept on file and copied to the Health & Safety Co-ordinator

Page 5 of 3