RISK ASSESSMENT RECORDING FORM

Location or
Address: House, living room
Activity or
Situation: Photoshoot
(1)

Hazard

Date Assessment
Undertaken:
Review
Date: 05/01/16

Assessment undertaken
By: Chloe Peacock
Signature

Risk

(2) Who might be harmed and how?

(3) What controls exist to reduce

risk

(4) What action can be taken to

There is a chance the equipment

could be knocked off the place where
it is being kept when it is not being
used 1/2
The dog that is present in the house
could try to attack someone 2/1

No one would be harmed but the

equipment would be broke and
unusable.

Move the equipment to a place

where is cant be knocked off.

Either the cast or the crew as the

dog could potentially bite anyone.

A drink could be split on the

equipment 2/2

No one would be harmed but the

equipment might become unusable.

Make sure the equipment is in the

protective bag so that if it is
knocked off it will protected from
the fall.
Keep the dog in a different room
from the living room so that it is
less likely to disturb us and
possibly hurt someone.
Keep all drinks away from the
equipment.

1. List hazards something with the potential to cause harm here:

further reduce risk?

Get someone to take the dog out

of the house why we take the
photos so there is no way it can
get us.
Keep the equipment in the
protective cases as this prevents
liquid getting on them easily.

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