PUBLIC HEALTH RISK ASSESSMENT TOOL

Public Health and Safety

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABILITY HUMAN PROPERTY BUSINESS PREPARED-
EVENT IMPACT IMPACT IMPACT NESS

Likelihood this will Possibility of death Physical losses Interuption of

Preplanning
occur or injury and damages services

0 = N/A 1= 0 = N/A 0 = N/A 0 = N/A 0 = N/A

SCORE Low 2= 1 = Low 1 = Low 1 = Low 1 = High
Moderate 3= 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 3
High 3 = High 3 = High 3 = High = Low or none

Penularan Covid
Kematian Covid
Kejadian HIV/AIDS
Kematian maternal
Kematian neonatal
Tidak memadai
tracing covid

Skrining hipertensi
tidak memadai

Skrining diabetes
tidak memadai

Meningkatnya
kejadian cancer
Coverage Imunisasi
Balita tidak tercapai
Coverage vaksinasi
Covid tidak tercapai

Kejadian malnutrisi

AVERAGE SCORE 0.00 0.00 0.00 0.00 0.00

*Threat increases with percentage.
0 RISK = PROBABILITY * SEVERITY
0 0.00 0.00 0.00
SSMENT TOOL
afety

DE - MITIGATION)
INTERNAL EXTERNAL RISK
RESPONSE RESPONSE
Community/
Time, effectivness,
Mutual Aid staff Relative threat*
resouces
and supplies

0 = N/A 0 = N/A
1 = High 1 = High
2 = Moderate 2 = Moderate 0 - 100%
3 = Low or none 3 = Low or none

0%
0%
0%
0%
0%

0%

0%

0%

0%

0%

0%

0%

0.00 0.00 0%
 PUBLIC HEALTH RISK ASSESSMENT TOOL
Occupational Health And Safety (K3)
SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILITY HUMAN PROPERTY BUSINESS PREPARED-
EVENT IMPACT IMPACT IMPACT NESS

Likelihood this will Possibility of Physical losses Interuption of

Preplanning
occur death or injury and damages services

0 = N/A
0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = Low
1 = Low 1 = Low 1 = Low 1 = High
SCORE 2 = Moderate
2 = Moderate
2 = Moderate 2 = Moderate 2 = Moderate 3
3 = High
3 = High 3 = High 3 = High = Low or none

paparan kimia
paparan gas CO2
paparan radiasi
trauma di perusahaan
gangguan muskulo
skeletal terkait akibat
kerja
paparan kebisingan
yang melebihi ambang
batas
burning
sindrome akibat kerja
ganggung mata akibat
kerja
insiden keselamatan
kerja
insiden kecelakaan lalu
lintas
Kekerasan di tempat
kerja

AVERAGE SCORE 0.00 0.00 0.00 0.00 0.00

*Threat increases with percentage.

0 RISK = PROBABILITY * SEVERITY
0 0.00 0.00 0.00
SMENT TOOL
afety (K3)
DE - MITIGATION)
INTERNAL EXTERNAL RISK
RESPONSE RESPONSE
Community/
Time, effectivness,
Mutual Aid staff Relative threat*
resouces
and supplies

0 = N/A 0 = N/A
1 = High 1 = High
2 = Moderate 2 = Moderate 0 - 100%
3 = Low or none 3 = Low or none

0%
0%
0%
0%

0%

0%

0%
0%

0%

0%

0%

0%

0.00 0.00 0%
 PUBLIC HEALTH RISK ASSESSMENT TOOL
Exposure In The Household
SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILITY
HUMAN PROPERTY BUSINESS PREPARED-
IMPACT IMPACT IMPACT NESS
EVENT
Likelihood this will Possibility of Physical losses Interuption of
Preplanning
occur death or injury and damages services

0 = N/A 0 = N/A
0 = N/A 0 = N/A 0 = N/A
1 = Low 1 = Low
1 = Low 1 = Low 1 = High
SCORE 2 = Moderate
2 = Moderate 2=
2 = Moderate 2 = Moderate 3
3 = High Moderate
3 = High 3 = High = Low or none
3 = High

paparan bahan kimia

paparan biologi

tersengat listrik

ventilasi yang tidak sesuai

polusi udara akibat uap

bahan kimiawi
polusi udara akibat
penggunaan pestisida
kecelakaan akibat
penggunaan peralatan di
dalam rumah
kekerasan fisik dalam rumat
tangga

perampokan

pembunuhan

jatuh

trauma akibat tertimpa

barang

AVERAGE 0.00 0.00 0.00 0.00 0.00

*Threat increases with percentage.

0 RISK = PROBABILITY * SEVERITY
0 0.00 0.00 0.00
MENT TOOL
old
UDE - MITIGATION)
RISK
INTERNAL EXTERNAL
RESPONSE RESPONSE

Community/
Time, effectivness,
Mutual Aid staff Relative threat*
resouces
and supplies

0 = N/A 0 = N/A
1 = High 1 = High
2 = Moderate 2 = Moderate 0 - 100%
3 = Low or none 3 = Low or none

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0.00 0.00 0%
 PUBLIC HEALTH RISK ASSESSMENT TOOL
Exposure In The Environment
SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILITY
HUMAN PROPERTY BUSINESS PREPARED-
IMPACT IMPACT IMPACT NESS
EVENT
Likelihood this will Possibility of Physical losses Interuption of
Preplanning
occur death or injury and damages services

0 = N/A 0 = N/A
0 = N/A 0 = N/A 0 = N/A
1 = Low 1 = Low
1 = Low 1 = Low 1 = High
SCORE 2 = Moderate
2 = Moderate 2=
2 = Moderate 2 = Moderate 3
3 = High Moderate
3 = High 3 = High = Low or none
3 = High

paparan bahan kimiawi

emisi CO2 yang tinggi

limbah berbahaya

radiasi

penggunaan tembakau

paparan terhadap timbal

kecelakaan lalu lintas

kecelakaan akibat kegiatan

olah raga
kecelakaan akibat aktifitas di
luar rumah

korban terorisme

korban perkosaan

korban kekerasan di luar

rumah

AVERAGE 0.00 0.00 0.00 0.00 0.00

*Threat increases with percentage.

0 RISK = PROBABILITY * SEVERITY
0 0.00 0.00 0.00
MENT TOOL
ment
UDE - MITIGATION)
RISK
INTERNAL EXTERNAL
RESPONSE RESPONSE

Community/
Time, effectivness,
Mutual Aid staff Relative threat*
resouces
and supplies

0 = N/A 0 = N/A
1 = High 1 = High
2 = Moderate 2 = Moderate 0 - 100%
3 = Low or none 3 = Low or none

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0.00 0.00 0%
 PUBLIC HEALTH RISK ASSESSMENT TOOL
Diet And Nutrition
SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILITY
HUMAN PROPERTY BUSINESS PREPARED-
IMPACT IMPACT IMPACT NESS
EVENT
Likelihood this will Possibility of Physical losses Interuption of
Preplanning
occur death or injury and damages services

0 = N/A 0 = N/A
0 = N/A 0 = N/A 0 = N/A
1 = Low 1 = Low
1 = Low 1 = Low 1 = High
SCORE 2 = Moderate
2 = Moderate 2=
2 = Moderate 2 = Moderate 3
3 = High Moderate
3 = High 3 = High = Low or none
3 = High
konumsi makanan yang
tercemar bakteri
konsumsi makanan yang
tercemar virus
konsumsi makanan yang
tercemar protozoa
konsumsi makanan yang
tercemar jamur
konsumsi makanan yang
tercemar bahan berbahaya
konsumsi makanan yang
tidak balans
konsumsi makanan yang
mengandung kolesterol
tinggi
kelaparan akibat kemiskinan

kelaparan akibat gangguan

psikologis
konsumsi makanan yang
sudah basi

gizi buruk pada balita

gzi buruk pada ibu hamil

AVERAGE 0.00 0.00 0.00 0.00 0.00

*Threat increases with percentage.

0 RISK = PROBABILITY * SEVERITY
0 0.00 0.00 0.00
MENT TOOL

UDE - MITIGATION)
RISK
INTERNAL EXTERNAL
RESPONSE RESPONSE

Community/
Time, effectivness,
Mutual Aid staff Relative threat*
resouces
and supplies

0 = N/A 0 = N/A
1 = High 1 = High
2 = Moderate 2 = Moderate 0 - 100%
3 = Low or none 3 = Low or none

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0.00 0.00 0%
 PUBLIC HEALTH RISK ASSESSMENT TOOL
Health Behavior
SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILITY
HUMAN PROPERTY BUSINESS PREPARED-
IMPACT IMPACT IMPACT NESS
EVENT
Likelihood this will Possibility of Physical losses Interuption of
Preplanning
occur death or injury and damages services

0 = N/A 0 = N/A
0 = N/A 0 = N/A 0 = N/A
1 = Low 1 = Low
1 = Low 1 = Low 1 = High
SCORE 2 = Moderate
2 = Moderate 2=
2 = Moderate 2 = Moderate 3
3 = High Moderate
3 = High 3 = High = Low or none
3 = High
Tidak melakukan kebersihan
tangan
Tidak menerapkan protokol
kesehatan pada AKB
Pola makan yang tidak
teratur
Perilaku BAB tidak di
jamban keluarga

Merokok di tempat umum

Membuang sampah di
termpat umum
Melakukan aktivitas yang
mencemari lingkungan
udara
Prilaku kekerasan psikologis

Pola tidur yang tidak sesuai

Melakukan aktivitas yang

mencemari lingkungan ai
Melakukan aktivitas yang
mengganggu mahluk hidup
di lingkungan

Perilaku kekerasan fisik

AVERAGE 0.00 0.00 0.00 0.00 0.00

*Threat increases with percentage.

0 RISK = PROBABILITY * SEVERITY
0 0.00 0.00 0.00
MENT TOOL

UDE - MITIGATION)
RISK
INTERNAL EXTERNAL
RESPONSE RESPONSE

Community/
Time, effectivness,
Mutual Aid staff Relative threat*
resouces
and supplies

0 = N/A 0 = N/A
1 = High 1 = High
2 = Moderate 2 = Moderate 0 - 100%
3 = Low or none 3 = Low or none

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0%

0.00 0.00 0%
 SUMMARY OF MEDICAL CENTER HAZARDS ANALYSIS

Diet And Nutrition

Exposure In The

Exposure In The
Occupational

Environment
Household
Public
Probability 0.00 0.00 0.00 0.00 0.00
Severity 0.00 0.00 0.00 0.00 0.00
Hazard Specific Relative Risk:
0.00 0.00 0.00 0.00 0.00

Hazard Specific Relative Risk to Medical Center

1.00

0.90
Relative Threat to Facility

0.80

0.70

0.60

0.50

0.40

0.30

0.20

0.10

0.00
Public Occupational Exposure In The Household Exposure In The Envi-
ronment

Probability and Severity of Hazards to Medical Center

1.00

0.90
Relative Impact on Facility

0.80

0.70

0.60

0.50

0.40

0.30

0.20
 0.80

Relative Impact on Faci

0.70

0.60

0.50

0.40

0.30

0.20

0.10

0.00
This document is a sample Hazard Vulnerability Analysis tool.Probability
It is not asubstitute for a comprehensive emergency preparedness program. Severity
Individuals or organizations using this tool are solely responsible for any hazard assessment and compliance with applicable laws and regulations.
 Total for Facility
Health Behavior

0.00 0.00
0.00 0.00

0.00 0.00

er

Exposure In The Envi- Diet And Nutrition Health Behavior

ronment
Severity