Working at Height - SH&E Risk Assessment

Project Name Main Contractor Reference

Project no. Subs Date

Client Assessor's Name Signature

Location Task Risk assessment type Initial Review

Risk assessment Risk assessment

(before controls) (after controls)

Hazards

Risk factor

Risk factor
Likelihood

Likelihood
Who affected How affected Controls to be implemented

Severity

Severity
(check all that apply) Risk Risk
level level

0 0 0 0

Working at Height - SHE Risk Assessment Revision 01 June 2020

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 Risk assessment Risk assessment

(before controls) (after controls)

Hazards

Risk factor

Risk factor
Likelihood

Likelihood
Who affected How affected Controls to be implemented

Severity

Severity
(check all that apply) Risk Risk
level level

0 0 0 0

0 0

Risk factor method Severity Likelihood Notes

Severity
1 2 3 4 5 Risk level 1 - No potential for injury, illness, or incident. 1 - Very Unlikely
Likelihood

2 4 6 8 10 Low 2 - Potential for minor injury, illness, or incident. 2 - Unlikely

3 6 9 12 15 Medium 3 - Potential for a recordable injury, illness, or incident. 3 - Likely
4 8 12 16 20 High 4 - Potential for major incident, or major injury or illness causing short term disability. 4 - Very Likely
5 10 15 20 25 5 - Potential for major incident, or major injury or illness causing a fatality or long term disability. 5 - Certain

Working at Height - SHE Risk Assessment Revision 01 June 2020

Page 2 of 2