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Risk Assessment Template 2

The risk assessment form documents potential hazards, risks, and controls at the Willow Park location. Hazards identified include slipping on wet ground, litter, and fallen branches. Existing controls are checking the area before activities. Further actions proposed are wearing appropriate footwear, clearing any litter or fallen branches, and checking the area before taking photos. The form also provides a risk rating matrix to evaluate risk levels and determine what action needs to be taken.

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tc04927885
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31 views2 pages

Risk Assessment Template 2

The risk assessment form documents potential hazards, risks, and controls at the Willow Park location. Hazards identified include slipping on wet ground, litter, and fallen branches. Existing controls are checking the area before activities. Further actions proposed are wearing appropriate footwear, clearing any litter or fallen branches, and checking the area before taking photos. The form also provides a risk rating matrix to evaluate risk levels and determine what action needs to be taken.

Uploaded by

tc04927885
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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RISK ASSESSMENT RECORDING FORM

Location or
Address: Willow Park
Activity or
Situation
(1)

Hazard

Date Assessment 10/01/15


Undertaken:
Review
Date:
Risk

Assessment undertaken
By: Tom Corcoran
Signature

(2) Who might be harmed and how?

(3) What controls exist to reduce


risk

(4) What action can be taken


to further reduce risk?

It could have rained so you could slip

The model

Check the area

Wear appropriate footwear

There could be litter

The model

Check the area

Clear the litter if there is any from


the area

There could be branches on the floor

The model

Check the area

Check the area before photos and


if needs be clear it

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


risk

(5) What action can be taken


to further reduce risk?

RISK RATING
a SEVERITY

b LIKELIHOOD

c FINAL SCORE RATING: what needs to be done

Dying or being permanently disabled

Will almost certainly happen

Serious injury/long term illness

Highly likely to happen

Temporary disability/3 days off sick

Not so likely

Will need medical attention

Even less likely

Minor injury eg. Bruise, graze

Unlikely to happen at all

16-25 Stop! Do not start activity again until risk is


controlled
10-15 High risk level, High priority. Take action
straight away to control the risk
6-9
Medium risk level. Tighten up controls and
make a plan to do something about risk
3-5
Fairly low risk level. Low priority but keep
possible action in mind
1-2
Low or trivial risk. No further action
required.

SO: a x b = c
Action Required

Responsible Person

Date for Completion

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