Risk Assessment Form
Company :
No Workplace Hazards
Workplace- Obstruction Presence of obstructions like low
Electrical Hazard
Run Date : 06/03/2022/07:34:42
Department:
Assessment of
Risk
(in relation to
Harm Caused By The Hazard & Who Existing Risk Controls workplace
Condition That Develop the Hazard hazards) Inherent
Might Be Harmed (in relation to workplace Risk
(in relation to workplace hazards)
(in relation to workplace hazards) hazards)
Risk
S P Level
R=SxP
Presence of these obstruction may
head space, sharp projections and cause Minor Injury (cuts and
partially blocked walkways bruises) to Operatives/Personnel
working in the area
Poor electrical wiring connection 1- Respiratory illness to Operatives
like octopus connection and due smoke from caused by the fire.
unsecured cables 2- Serious injuries, burns from the
accidental fire
3- Damaged to property caused by
accidental fire from electric short
circuits or unsecured cables
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 Site Name:

Re-evaluated
Risk
(in relation to Description of
workplace hazards) Monitoring
Further Risk Controls Required Residual
Risk
Required
(in relation to workplace hazards)
New (in relation fo
Risk residual risk)
S P
Level
R=SxP

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 Risk Assessment Form - DAY1
Company : Department:

Assessment of
Risk
Condition That Develop the Harm Caused By The Hazard (in relation to
Existing Risk Controls workplace hazards) Inherent Further Risk Controls Required
Workplace Hazard & Who Might Be Harmed
No (in relation to workplace Risk
Hazards (in relation to workplace (in relation to workplace (in relation to workplace hazards)
hazards)
hazards) hazards)
Risk
S P Level
R=SxP

"THIS AREA FOR HAZID"

2
(Each Group has to Identify Eight (8) Workplace "DO NOT FILL THIS AREA"
Hazards - Photos available in Sheets #1 to #28)
3

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Site Name:

Re-evaluated
Risk
(in relation to Description of
workplace hazards) Monitoring
Residual
Risk
Required
(in relation fo
New Risk residual risk)
S P Level
R=SxP

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 Risk Assessment Form - Day2
Company : Department:

Assessment of
Risk
Condition That Develop the Harm Caused By The Hazard (in relation to
Existing Risk Controls workplace hazards) Inherent Further Risk Controls Required
Workplace Hazard & Who Might Be Harmed
No (in relation to workplace Risk
Hazards (in relation to workplace (in relation to workplace (in relation to workplace hazards)
hazards)
hazards) hazards)
Risk
S P Level
R=SxP

#9 Electrical Hazard/ Poor electrical wiring connection These hazard can cause Minor Injury None 3 4 12 Post signages, organize wirings and orient
Trip Hazard like unsecured cables, and like (slip, trip , falls and sprain)and workers in the area about the hazard.
partially blocking walkways. also Major injury ( fractures and
dislocation to Operatives/Personnel Intolerabl
1 that are working in the area. e

#6 Ergonomic Hazard/ Poor workstation setup in an It may cause to Minor Injury like None 2 3 6 Organizing loose objects, Eliminate objects that
Trip Hazard office, poor housekeeping (slips, trips and fall) over loose object are not necessary in the workplace.
improperly designed tools or on floors to personnel at the working
2 equipment and partially blocking area. Undesirab
walkways le

#11 Electrical Hazard improper connection like It may cause to damage to property None 4 4 16 Remove foreign objects stored on the top of the
unsecured cables like (octupus caused by accidental fire from disconnect
3 connection) electric short circuits or unsecured Intolerabl
cables e

#12 Fire Hazard presence of obstruction and it may cause minor injury and if ever Signanges 3 4 12 Eliminate any objects/things that blocking the
partially blocked and unsafe they have emergency it can't easily exits. Post visible signages.
walkways go to exit
Emergencies can happen at any
time. Blocking or partially blocking an Intolerabl
4
exit route even for a short period e
puts employees at risk

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 Assessment of
Risk
Condition That Develop the Harm Caused By The Hazard (in relation to
Existing Risk Controls workplace hazards) Inherent Further Risk Controls Required
Workplace Hazard & Who Might Be Harmed
No (in relation to workplace Risk
Hazards (in relation to workplace (in relation to workplace (in relation to workplace hazards)
hazards)
hazards) hazards)
Risk
S P Level
R=SxP

#3 Housekeeping Cluttered and poorly arrange The presence of the said materials none 3 3 9 1. Conduct proper housekeeping activities eg.
Hazard materials like wood,, galvanized may cause Minor Injury such as cuts Removal of unecessary items, orderly piling of
roof, pipes and tiles. Blocked aisle and bruises to personnel. Undesirab materails. 2. Seminar for proper housekeeping.
5 ways le

#19 Fire Hazard cigarette butts left behind the 1. May cause serious injuries like Signanges 5 5 25 1- Orientation/training about fire hazard.
workplace burns from the fire incident to 2- Conduct thorough inspection in the workplace.
Personnel/Operative. 2.Death 3. None 3- Limit the accessibility to the area specially
6 Damage to property caused by fire Operable during break time.
4- Installation of cctv to secure the area and
caught the personel(s) who does not abide the
rules and regulation.
Erogonomic hazard, Defective Grinding Guard, Eye Infection, Minor Injury for the none 4 4 16 Replace the grinding
1. Orientation/ guard
training andthe
about replace
hazard.the2.power
Chemical and Electric Improper wire management of personnel/user cord. Even
Conduct better ifinspection
thorough the powerintool
theitself is
workplace. 3.
Hazard the power tool replaced
Limit the accesesibility to the area specially during
Defective Grinding Guard, break time. 4. Installation of cctv to secure the
Improper wire management of area and caught the personnel who does not
the power tool Intolerabl abide the rules and regulation.
7 Defective Grinding Guard, e
Improper wire management of
the power tool
Defective Grinding Guard,
Improper wire management of
the power tool
Defective Grinding Guard,
Electrical Hazard Improper
Poor wire
wiring andmanagement
octopus of Damaged to Property, Accidental None Use cable ties and cable cords sleeves to manage
the power tool
connection. Fires, The wire may short circuit the wires. Also, avoid using extension as possible.
Defective grinding guard, because of its faulty condition
8 Improper wire management of 4 4 16 Intolerabl Label the power outlet.
e
the power tool.

#4 Electric Hazard/Fire Improper connection of wirings Due to improper use of wiring and none 1. regularly inspect buildings and equipment 2.
Hazard like unsecured connection lack of knowledge in electrical build employee awareness and traning programs.
between the wire and outlet circuits this may cause electric 3. designate internal safety officers.
shocks, electrocution to the person Intolerabl
and also can form a fire because of a 3 4 12 e
short circuit.

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 Assessment of
Risk
Condition That Develop the Harm Caused By The Hazard (in relation to
Existing Risk Controls workplace hazards) Inherent Further Risk Controls Required
Workplace Hazard & Who Might Be Harmed
No (in relation to workplace Risk
Hazards (in relation to workplace (in relation to workplace (in relation to workplace hazards)
hazards)
hazards) hazards)
Risk
S P Level
R=SxP

#22Chemical Hazard/ Oil and oxygen cant be together Explosion due to heat temperature, none Use of proper ppe specially masks/respirators to
Fire Hazard because they are both people working in the area and avoid the inhalation of the chemicals and also
flammable. people around that place will be None avoid entering the area with things that may cause
harmed. 4 5 20 Operable hazard/ignition

GROUP/ROOM 10 MEMBERS

Rob Miguel C. Pentinio

Pathima Vera G. Aguilar
Sameach Silang "THIS
Jeruel Dave Hernandez (Each Grou
Joanne M. Balmes Hazards - P
Jaiceline Abella
Karen Predilla Villena

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Site Name:

Re-evaluated
Risk
(in relation to Description of
workplace hazards) Monitoring
Residual
Risk
Required
(in relation fo
New Risk residual risk)
S P Level
R=SxP

1 2 2 Weekly monitoring of
signages if its still
there or visible.
Acceptable

2 2 4 Continuous
monitoring of the
area to identify if
Acceptable there is loose objects
that may cause
hazard

2 2 4 Continuous
monitoring
Acceptable

2 2 4 Always check the

exits/workplace

Acceptable

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 Re-evaluated
Risk
(in relation to Description of
workplace hazards) Monitoring
Residual
Risk
Required
(in relation fo
New Risk residual risk)
S P Level
R=SxP

1 1 1 Continuous
monitoring
Negligible

2 1 2 everyday

Acceptable

1 1 1 Continuous
monitoring

Negligible

weekly

2 2 4 Acceptable

everyday

2 2 4 Acceptable

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 Re-evaluated
Risk
(in relation to Description of
workplace hazards) Monitoring
Residual
Risk
Required
(in relation fo
New Risk residual risk)
S P Level
R=SxP

everyday

2 2 4 Acceptable

"DO NOT FILL THIS AREA"

THIS AREA FOR HAZID"

h Group has to Identify Eight (8) Workplace
ards - Photos available in Sheets #1 to #28)

"This Area for

Assessing Risk"

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 Risk Assessment Matrix
Consequence Probability (P)
1 2 3
IMPROBABLE UNLIKELY POSSIBLE
Severity - Never heard of in Industry - Heard of in Industry
- Very unlikely - Not likely to occur
- Incident has occurred in
our company
(S) People Assets Environment Reputation
- Maybe exposed to hazard - Yearly or maybe exposed
to hazard infrequently
- Likely to occur sometime
- Monthly or exposed to
hazard several times

1 Slight Health
Effect/Injury
Slight Damage Slight Effect Slight Impact 1 2 3

2 Minor Health
Effect/Injury
Minor Damage Minor Effect Limited Impact 2 4 6

3 Major Health
Effect/Injury Localised Damage Localised Effect
Considerable
Impact 3 6 9

4 Potential for 1-3

Fatalities Major Damage Major Effect National Impact 4 8 12

5 Multiple Fatalities Extensive Damage Massive Effect

International
Impact 5 10 15

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 25 to 20 None Operable Evacuate Zone

10 to 16 Intolerable Do not take the Risk

5 to 9 Undesirable Demonstrate ALARP before proceeding

2 to 4 Acceptable Proceed carefully with continuous improvement

1 Negligible Safe to Proceed

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ity (P)
4 5
LIKELY PROBABLE
- Happens several times per - Happens several times per
year in Industry year in our company
- Likely to occur several - Likely to occur repeatedly
times - Continuous exposed to
- Weekly or exposed to hazard
hazard often

4 5

8 10

12 15

16 20

20 25

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