Risk Assessment Template

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RISK ASSESSMENT RECORDING FORM

Location or
Address: 10 Guernsey close
Activity or
Situation photoshoot
(1)

Hazard

Date Assessment
Undertaken: 4th march 2016
Review
Date:
Risk

Assessment undertaken
By: Liam Lynn
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?

Falling off the decking.

The model could trip over on the


decking.

Be sensible on the decking and


use the step to get onto it.

A railing or fence could be put


around the side of the decking to
reduce the risk of falling.

A risk of fire in the kitchen

If any appliances are accidentally


left on in the kitchen it could cause a
fire and harm the model or
photographer.

Make sure all the appliances are


switched off or are away from
anything flammable.

Unplug and remove all of the


appliances from the kitchen.

Glasses in the kitchen could get


smashed

If any glass was to get smashed in


the kitchen it could harm both the
model and photographer.

Make sure all the glasses are put


back into the cupboard and not left
out on the side.

The fire place in the living room could


cause a fire

If the fireplace was to cause a fire in


the living room the model and
photographer may be harmed and
anybody else in the house could be
harmed.

Make sure that there is nothing


flammable near the fire place and
make sure it is turned off while the
photoshoot is taking place.

Take all of the glasses out of the


kitchen and put them in a different
room while the photoshoot is
taking place.
To reduce the risk further the gas
in the house could be switched off
to ensure no possible fires.

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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