Risk Assessment – Hazard Inspection Checklist

This document is to completed upon regular inspection of the workplace as part of

standard WHS procedures for the workplace. All sections of this document must be
completed.
Name of organization: Matchworks
Address: 66 victor cres
Description of venue: Office
Inspection detail

Site hazard inspection Stevie

checklist completed by:

Work location inspected: Office

Area inspected: Office

Date of inspection 13/2/23

Report submitted to William

Date report submitted 14/2/23

In the checklist headings these terms are used:

Yes – hazard identified
No – no hazard identified

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 Section 1 Hazard identification
Facilities
Observation item Yes No Comment/recommendation
Building and fixtures
4 Blinds are broken
Footpath/walkway
4 pathways clear
Playground
4 no playground
Swimming pool
4
Other
4
Environment
Observation item Yes No Comment/recommendation
Sun/UV exposure
4 Blinds are broken
Temperature/weather
4
Sound/noise
4
Water
4
Fauna (animals, insects)
4
Other
4
Chemicals (please refer to Safety data sheets for all chemicals)
Observation item Yes No Comment/recommendation
Hazardous chemicals
4 chemicals
Non-hazardous chemicals
4

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 Biological
Observation item Yes No Comment/recommendation
Bodily fluids
4
Food handling
4 Area has not been kept clean
Other
4
Energy
Observation item Yes No Comment/recommendation
Electricity
4 recently tested
Gas
4 no gas

Manual tasks/ergonomics
Observation item Yes No Comment/recommendation
Lifting
4
Heights
4
Space (restricted)
4
Other

Personnel
Observation item Yes No Comment/recommendation
Clients
4
Staff
4
Carers/parents
4
Other
4

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 Other hazards

Details:

N/A

Section 2 Risk matrix

Which consequences are possible outcomes for this risk? Use the table to determine
the risk rating (number).

How does the table work?

Match the consequence to the likelihood in each row to find the risk rating for each
consequence. Some consequences may not be likely at all so will not attract a
number rating. The lower the number the higher the risk.

Your overall risk rating is the lowest number.

Highly 11 Unlikely to Likely to Highly likely to
Consequence unlikely to occur 2 occur I occur 4
occur 3
Death, permanent disability
or serious illness 3 2 1 1
Serious injury 4 3 2 1
Medical attention and time
absent from work 5 4 3 2
First aid or minimal attention 6 5 4 3
Section 3 Hierarchy of control
Risks can be controlled by taking preventative action. The options available to
control risks are listed in order of effectiveness. They are:
111
1. Elimination 1- work on one hazard identified from above check list
2. Substitution 2- look at first consicence pick which1box you think it fits
3. Isolation 3-reapeat three more times
4. Engineering 4-look at the ticks and come up with an avarage (1-4)
5. Administration 5-write avarage in hazards below
6. PPE
Elimination is the most effective. PPE is the least effective.

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 Section 4 Control risks
What to do:
List any hazards identified in Section 1 Hazard identification
Rate each hazard using Section 2 Risk matrix
Identify the control measures for each hazard
Identify the person responsible for actioning the hazard

Hazard 1:
Overall risk rating (number) for hazard 1: 2
Control measures for hazard 1: Replace blind

☐ Elimination

4☐ Substitution

☐ Isolation

☐ Engineering

☐ Administration

☐ PPE
Person responsible for hazard 1:
Name: John Doe
Position: Handy man
Date to be actioned: after inspection date 23/2/23

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Hazard 2:
Overall risk rating (number) for hazard 2: 3
Control measures for hazard 2: Hazardous chemicals

☐ Elimination

☐ Substitution

4☐ Isolation

☐ Engineering

☐ Administration

4☐ PPE
Person responsible for hazard 2:
Name: Mary Sue
Position: Manager
Date to be actioned: 24/2/23

Hazard 3:
Overall risk rating (number) for hazard 3: 2
Control measures for hazard 3: Unclean Kitchen

4☐ Elimination

☐ Substitution

☐ Isolation

☐ Engineering

☐ Administration

☐ PPE

Person responsible for hazard 3:

Name: All Staff
Position: All staff
Date to be actioned: 22/2/23

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Hazard 4:
Overall risk rating (number) for hazard 4:
Control measures for hazard 4:

☐ Elimination

☐ Substitution

☐ Isolation

☐ Engineering

☐ Administration

☐ PPE
Person responsible for hazard 4:
Name:
Position:
Date to be actioned:

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