Risk

Assess
ment
Form
Part A
Reference:

Alex Madej
Kira Bannard

Sign-off
status

[enter reference
number]]

[planning/approved etc]

Assessment
summary
details
Assessment title

Poison

(Simple name for

reference purposes)

Division:*

Series/
Prod/Unit:

Responsible
Manager:

Brendan
Sheppard

Address/Tel:

The Netherhall
School and
Sixth Form
Centre
Queen Ediths
Way Cambridge

Date assessment
created

Department:*
Programme/Are
a:

Contact office:
Address/Tel:

Media

Media
The Netherhall School and Sixth
Form Centre
Queen Ediths
Way
Cambridge

Confidential risk
assessment?

Assessment
Outline
(Summary of what
is proposed)

17/11/15

Review / End
date

17/11/15

Country location

Untied Kingdom

Hostile / travel
advisory?

None

Location details

The Netherhall
School and
Sixth Form
Centre
Queen Ediths
Way
Cambridge

NB: If the country location selected is Hostile you

are required to: complete the BBC Overseas High Risk
Assessment Form

Assessment start
date

Crew / team
(Roles,
responsibilities,
competencies)

Alex Madej- assistant director/producer Camera Operator?, Lighting and editor

Attachments
(Detail supporting

N/A

Kira Bannard: Producer/director

Gus- Camera operator? TBC

documents)

Assessor(s)

(Person drafting
risk assessment)

Brendan
Sheppard

Authoriser(s) *
(Person responsible
for sign-off)

Distribution
(Who gets a copy
of the assessment)

Assessor safety
competence

Brendan Shappard

Date signed-off
*

Data Protection Act: Personal information collected for the purposes of risk assessment will be used to
identify those at risk, and those involved in controlling risk, from this or similar activities and to fulfil the
BBC's obligations under Health and Safety policy and legislation. It will be retained for up to 6 years after the
expiry of the activity. It may be shared with other organisations, including our agents and contractors, with
whom the risk or the control of risk is shared.

Activity and Hazard Summary

[This is a summary of the activities listed in part B of

the risk assessment.]

Activity

Who Exposed

Hazards{hazard
titles

Activity Risk Rating

Date / time
received

Comments

Assessor
response

Comments log
Who by

Date/ time
responded

Risk
Assessme
nt Form
Part B
Reference:

[enter reference
number]]

Sign-off status

[planning/approved
etc]

Activity Title:*

Media production- Filming a Film Noir

opening sequence (2-3min)

Activity Description:

3 actors an an office with one being

poisoned and falling to the floor

List those managing this Activity and

their competence:

Kira Bannard:
Alex Madej:

Who & how many are at risk from this

Activity?

Hazards
How could someone become hurt or made ill

Control measures
How are you going to prevent this from
happening?

Accidentally tripping over loose wires across

the floor

Tape all cables and wires to the ground and

plug into appropriate sockets or extension
leads

Risk Level*: After your controls have

been applied what is your assessment of
the risk level of this activity?

Low

Hazards
How could someone become hurt or made ill

Control measures
How are you going to prevent this from
happening?

Burning hand on light

Always wear gloves during and after the

lights have been on to prevent your skin

touching the extremely hot lights.

Risk Level*: After your controls have

been applied what is your assessment of
the risk level of this activity?

Medium

Hazards
How could someone become hurt or made ill

Control measures
How are you going to prevent this from
happening?

Being blinded by the lights

Floor manager/ lighting person to warn

actors/crew that lights are coming on and
do not look into them to prevent
disorientation to the eyes or causing serious
damage.

Risk Level*: After your controls have

been applied what is your assessment of
the risk level of this activity?

Medium

Hazards
How could someone become hurt or made ill

Control measures
How are you going to prevent this from
happening?

Falling over/crashing town onto equipment or

people due to poor visibility.

Make sure actors or production crew know

where they are stations and where they
need to go or move around the studio floor
without injuring themselves or others

Risk Level*: After your controls have

been applied what is your assessment of
the risk level of this activity?

low