Baseline Risk Assessment

AREA OF ASSESSMENT:

DATE OF ASSESSMENT:

ASSESSOR’S NAME:

Physical Items / Risk

No Hazard / Risk Existing Controls Sev Likel Recommended Controls
Activity Level

Risk Level Calculator Risk Level Action

1-5 = Small Risk Acceptable
S - Severity of Risk 1 = No Injury 2 = Slight Injury 3 = Minor 4 = Major 5 = Fatality 6-10 = Medium Risk Requires Monitoring
L - Likelihood of Events 1 = Very Unlikely 2 = Unlikely 3 = Likely 4 = Very Likely 5 = Inevitable 11 -15 = Sever Risk Immediate Action
Risk Rating = A x B 15+ = Emergency Risk Stop work and Review Page 1 of 1