OHS Hazard Report Form

09/3/16
Date:
Reported By:
Nicolas Ugarte
Name:

Student
Position:

Reported To:
Name:

Principal and OHS Rep

Site location:

Position:

Principal and OHS Rep

FOR 1.1

Subject:
Incident

Near Miss

Workplace Hazard

Hazardous Work Practice

Description of Hazard: The railing near the entrance of classroom FOR 1.1 has an un-stable
railing that may cause injury to a person if they put their weight or rely on this railing. The
stairs near this railing can be seen as a trip hazard if support isnt properly provided.

Risk Assessment Levels

-How likely is the hazard to hurt me or someone else?

Not likely
Some likelihood
Quite likely
Extremely likely
-How badly could people be hurt?
Not badly
Somewhat badly
Quite badly
Extremely badly
Explain your answer here.
If weight is put the railing and the railing breaks, this could injure any parties involved. There is also a
slight fall next to the stairs that could add that much of a difference that bones may break or fracture in
the event that this could happen in.

What needs to be done?

Elimination
Substitution
Isolation
Safeguards
Instructing workers in the safest way to do something
Using personal protective equipment and clothing (PPE)
Other
Provide details below.
There needs to be consideration that this part of structure is faulty in giving reliable and safe
grounding for all people who use it or may need to use it. It should be replaced, a different
hand rail should be implemented and there should be safeguards people need to learn when
using or being close to the rail in question, can acquire a safe and reliable technique or avoid
this railing after taking precautious steps.

Signature:

Date:
9/3/16

Copy given to: Toni Sanfilippo

Manager:

(Signature)

Communication Meeting:

(Signature)