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Media & Communication School of Art & Design Coventry University

RISK ASSESSMENT FORM


Production name: Choices The Film Location: 3 Brunswick Square, Brindleyplace, B1 2HR Shoot dates: 02/03/12 Crew names and mobiles: Kelvin Fred-Horsfall (07956055994) / Tayo Daramola (07943465754) Complete the following table rating each risks severity on scale from Negligible (N), Low risk (L), Moderate risk (M), Severe (S), Very severe (V) each risks likelihood on scale from Very unlikely (VU), Unlikely (U), Possible (P), Likely (L), Very likely (VL) Determine the risk factor from the table overleaf.

Hazard

Present?

Severity

Likelihood

Risk Factor

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33

Alcohol/drugs Animals/insects Audiences Camera cable/grip equipment Confined spaces Derelict buildings/dangerous structures Electricity/gas (other than normal supplies) Fatigue/long hours Fire/flammable materials and heat Hazardous substances Heat/Cold/extreme weather Laser/strobe effects Machinery/industrial/ crane/hoist Materials - glass, non-fire retardant set materials Night operation Noise high sound levels Non standard manual handling Public/crowds Radiation Scaffold/Rostra Smoking on set Special effects/explosives Special needs (elderly, disabled, inexperienced) Specialised rescue/first aid Stunts, dangerous activities Tall scenery/suspended ceilings Travelling to and from shoots Tripping/falling Vehicles/speed Water/proximity to water Weapons Working at heights Working overseas

N N N Y N N N N N N N N N N N N N N N N N N N Y N N N N N N N N N

N N N N L N N L N N N N N N N N N N N N N N N L N N N M N N N N N

VU VU VU P U VU VU U VU VU VU VU VU VU VU P VU VU VU VU VU VU VU U VU VU VU U VU VU VU VU VU

1 1 1 2 2 1 1 2 1 1 1 1 1 1 1 2 1 1 1 1 1 1 1 2 1 1 1 2 1 1 1 1 1

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Other risks: please detail.

VU

Calculate the Risk Factor: Very Unlikely 3 2 2 1 1 Unlikely 4 3 2 2 1 Possible 4 3 3 2 2 Likely 5 3 3 3 2 Very Likely 5 5 3 3 3

Very severe Severe Moderate Slight Negligible

Decide the action to take: 5 4 3 2 1 Very severe Severe Moderate Risk Low Risk Negligible Take immediate action/abandon location High priority Programme for action Action may be required Probably acceptable

Then list each risk identified Hazard no: Description Tripping/Falling Risk Factor (1-5) (2)

Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) ) Action to take

Members on set (Cast & Crew)

Ensure wiring is taped down and that everyone present is aware of the risk.

Person/company Kelvin Fred-Horsfall responsible for action To be completed at agreed later date Exposed person(s) Y Agreed action taken? (y/n) informed? (y/n)

Risk removed? (y/n)

Copy and paste this table for each of the hazards, then get the form signed. If the producer has not completed the risk assessment, then they should countersign this form. Completed by: Kelvin Fred-Horsfall Signature: K.Horsfall Countersigned by: Tayo Daramola Signature: T.Daramola Position: Producer Date: 23.02.12 PRODUCER Date: 23.02.12

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