RISK ASSESSMENT RECORDING FORM

Location or Date Assessment Assessment undertaken

Address: 72 Manchester road Undertaken: 16/02/23 By: Matthew McMillan
Activity or Review Signature
Situation Date: X

(1) Hazard Risk (2) Who might be harmed and (3) What controls exist to reduce (4) What action can be taken
how? risk to further reduce risk?
The people that would be affected I could reduce the risk by ensuring N/A
Tripping over stone steps a1xb3 would be my singer as he could that when my singer is singing that
=3 trip and fall over the stone steps he is not near the stones

Tripping over the bins a1xb3 The people that would be harmed Make sure they are as close to the Take the bins out of the back
=3 would be my singer as he could walls as possible to ensure there is garden for space
fall over the bins more space

If it is bad weather and rain gets on a2xb2 The people that would be affected Ensure that I check what the Ensure that if it does rain i bring
equipment =4 would be myself as rain could get forecast is going to look like before clothing or an umbrella to protect
into the equipment I am using to I shoot the equipment
shoot my music video with

Slipping on moss on the stone tiles a2xb2 The people hat would be affected Ensure that before I shoot my To take further action we would
=4 would be myself and also my music video that the stone tiles are have clean off the stone tiles
singer as we could slip and hurt clean ourselves and delay production
ourselves on the moss
 1. List hazards something with the potential to cause harm here:
Seek to quantify the level of risk the likelihood of harm arising based on the number of persons affected, how often they are exposed to the hazard and the
severity of any consequence.
2. List groups of people who are especially at risk from the significant hazards which you have identified
3. List existing controls here or note where the information may be found
4. List the risks which are not adequately controlled and the action you will take. Have regard for the level of risk, the cost of any action and the benefit you expect to
gain.

(1) Hazard Risk (2) Who might be harmed and how? (3) What controls exist to reduce (5) What action can be taken
risk to further reduce risk?

RISK RATING

a SEVERITY b LIKELIHOOD c FINAL SCORE RATING: what needs to be done

5 Dying or being permanently disabled
4 Serious injury/long term illness
3 Temporary disability/3 days off sick
2 Will need medical attention
1 Minor injury eg. Bruise, graze
Action Required
5 Will almost certainly happen 16-25 Stop! Do not start activity again until risk is
controlled
4 Highly likely to happen 10-15 High risk level, High priority. Take action
straight away to control the risk
3 Not so likely 6-9 Medium risk level. Tighten up controls and
make a plan to do something about risk
2 Even less likely 3-5 Fairly low risk level. Low priority but keep
possible action in mind
1 Unlikely to happen at all 1-2 Low or trivial risk. No further action
required.
SO: a x b = c
Responsible Person Date for Completion