RISK ASSESSMENT RECORDING FORM

Location or
Address: Wilder spool causeway
Activity or
Situation: Photo shoot
(1)

Hazard

Date Assessment
Undertaken: 26/01/16
Review
Date:

Assessment undertaken
By: Ricky Chin
Signature: Ricky Chin

Risk

(2) Who might be harmed and how?

(3) What controls exist to reduce

risk

(4) What action can be taken

Tripping over tree branch

A1
B2

Crew member by walking and

tripping over a branch

Make sure to look where they are

stepping

Removing any tree branch in the

area of Photo shoot

Slipping on muddy grass

A1
B3

Crew member walking on grass that

might of rain before

Being careful where they step

If the grass is wet reschedule the

date for photo shoot

Hitting head on wall

A1
B3

Crew member could be leaning and

slip onto the wall

Making sure that he is stepping

carefully

Make sure that the shoes has a

good grip

Tripping over equipment

A1
B2

Crew member walking and tripping

over equipment bag

Tell the crew where the bags and

equipment is going to be put

Making sure that its all put to one

side and out of the way of area
around the photo shoot

Tripping on playground

A1
B2

Crew member by walking around on

the playground

Being careful where stepping

Cancel the photo shoot for that

day if its raining or if the
playground is wet

To further reduce risk?

1. List hazards something with the potential to cause harm here:

Seek to quantify the level of risk the likelihood of harm arising based on the number of persons affected, how often they are exposed to the hazard and the
severity of any consequence.
2. List groups of people who are especially at risk from the significant hazards which you have identified
3. List existing controls here or note where the information may be found
4. List the risks which are not adequately controlled and the action you will take. Have regard for the level of risk, the cost of any action and the benefit you expect to
gain.

(1)

Hazard

Risk

(2) Who might be harmed and how?

(3) What controls exist to reduce

risk

(5) What action can be taken

to further reduce risk?

RISK RATING
a SEVERITY

b LIKELIHOOD

c FINAL SCORE RATING: what needs to be done

Dying or being permanently disabled

Will almost certainly happen

Serious injury/long term illness

Highly likely to happen

Temporary disability/3 days off sick

Not so likely

Will need medical attention

Even less likely

Minor injury eg. Bruise, graze

Unlikely to happen at all

16-25 Stop! Do not start activity again until risk is

controlled
10-15 High risk level, High priority. Take action
straight away to control the risk
6-9
Medium risk level. Tighten up controls and
make a plan to do something about risk
3-5
Fairly low risk level. Low priority but keep
possible action in mind
1-2
Low or trivial risk. No further action
required.

SO: a x b = c
Action Required

Responsible Person

Date for Completion