Evolution Hospitality Institute

Risk Assessment Matrix

How dangerous is the risk you have found?

What is the probability of it happening?

How severely could it hurt someone or how VERY LIKELY LIKELY UNLIKELY VERY UNLIKELY
ill could it make someone?
Could happen at any time Could happen sometime Could happen but very rarely Could happen but probably never
will

Kill or cause permanent disability or ill

1 1 2 3
health (C1)

Long term illness or serious injury (C2) 1 2 3 4

Lost time injury (C4) 2 3 4 5

Basic first aid needed (C1) 3 4 5 6

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Risk Assessment Form

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 Record of work health and safety (WHS) meeting

Department:

Time: ____:____am/pm Location: ____________________________

Attendees:
Name: Signature:
Name: Signature:
Name: Signature:

HSR Rep:

Name: Signature:

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What is the health and safety issue:
Lift up heavy stuff with chance of get injury on the back, didn’t put any sign when there was
slippery, don’t use PPE equipment, possibility contamination of food

Responsibility for follow-up and action:

Assigned to:

Name: stefano Due Date:24/4/2021 Date Completed: should include

signature here of person who
completed action

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What decision/s have been made:

Due date met Date of

Action items Person responsible Due date Reason date not met
Y or N completion
1)employee lift up a heavy pot of 25 Possibility of injury on her -Warning 24/4/2021 Kitchen supervisor 24/4/2021
kg stock by herself back Chance to spill stock because the Feedback
procedures
herself Training
haven’t been
Chance to spill stock on followed. scheduled for
other staff next week
-Feedback
Possibility to fall over Follow up
-Re-training
spilling hot stock
-allocate this task
to 2 people
2) employee didn’t use PPE Possibility injuries on his -Warning 24/4/2021 Kitchen supervisor 24/4/2021
equipment to clean flat top grill hands, arms, face and because the Feedback
eyes by spilling acid or procedures
inhale vapour haven’t been Put up more
followed signs
Chance to be blind or
serious eyes injuries. Follow up
- Feedback
Retraining on
safety procedures
3) Chef used 2 blow torch at the Risk of overheat both of -Warning 24/4/2021 All staff 24/4/2021
same time close to each other gas bottle because he used Have only 1 blow
Risk of serious injuries a dangerous torch in the kitchen
procedures
- Feed back
4) sous chef store a plastic bag Wrong shelve and Warning because 24/4/2021 Head chef 7/3/2021
with raw chicken on the middle possibility of cross the procedures Label shelf
shelve in the coolroom contamination by spilling haven’t been
Use tray to store
liquid on the food below it followed

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 Possibility of make Feedback raw meat
costumers sick Add sign at the
entrance of the cool
room.
5) Fire extinguisher expired Report to business 24/4/2021 - Owner Create a reminder
- Not useful in case of fire owner Replace the Head chef to check
extinguisher extinguisher
- Implement risk
Maintain record
Risk of getting fine
6) Broken equipment (missing lid of - Possibility of have 24/4/2021 - All staff Replace new one
robo cop) serious injure of hands. - Report to Feedback
supervisor
Replace new or
have maintenance
of equipment

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