5x5 Risk Matrix Template - duplicate

• Site:

  Select
• Location (if site is not predefined):
  Address

• Conducted On:

  Date

• Prepared By:

• Project:

• Refer to the table below when completing this 5x5 risk matrix template.

  

Risk Matrix: Probability

• Probability of Risk

• Unlikely to happen and/or have minor or negligible consequences. Okay to go ahead.

• Possible this could happen and/or to have moderate consequences. May go ahead but preferably reduce risk.

• Likely to happen and/or to have serious consequences. Do not allow transaction until risk reduced.

• Almost sure to happen and/or to have major consequences. Do not allow transaction to occur or reduce the risk to acceptable level.

• Sure to happen and/or have major consequences. Do not allow transaction, change, or operations.

Risk Matrix: Impact

• Impact of Risk

• Won’t cause serious injuries or illnesses

• Can cause injuries or illnesses, only to a mild extent

• Can cause injuries or illnesses that may require medical attention but limited treatment

• Can cause irreversible injuries or illnesses that require constant medical attention

• Can result to fatality

Risk Matrix: Level of Risk

• Multiply the value of Probability with the value of Impact to get this score.

• Risk Level

• Acceptable: no further action required, but ensure controls are maintained

  

• Adequate: consider for further analysis

  

• Tolerable: review in a timely manner to carry out improvement strategies

  

• Unacceptable: cease activities and endorse immediate action

  

Controls

• Select control measures

  Select Elimination Substitution Engineering Controls Administrative Controls PPE Other

  • Elimination
  • Substitution
  • Engineering Controls
  • Administrative Controls
  • PPE
  • Other

• Please specify

Sign-off

• Sign-off

  Sign

5x5 Risk

• Refer to the table below when completing this 5x5 risk matrix template.

  

Risk Matrix: Probability

• Probability of Risk

• Unlikely to happen and/or have minor or negligible consequences. Okay to go ahead.

• Possible this could happen and/or to have moderate consequences. May go ahead but preferably reduce risk.

• Likely to happen and/or to have serious consequences. Do not allow transaction until risk reduced.

• Almost sure to happen and/or to have major consequences. Do not allow transaction to occur or reduce the risk to acceptable level.

• Sure to happen and/or have major consequences. Do not allow transaction, change, or operations.

Risk Matrix: Impact

• Impact of Risk

• Won’t cause serious injuries or illnesses

• Can cause injuries or illnesses, only to a mild extent

• Can cause injuries or illnesses that may require medical attention but limited treatment

• Can cause irreversible injuries or illnesses that require constant medical attention

• Can result to fatality

Risk Matrix: Level of Risk

• Multiply the value of Probability with the value of Impact to get this score.

• Risk Level

• Acceptable: no further action required, but ensure controls are maintained

  

• Adequate: consider for further analysis

  

• Tolerable: review in a timely manner to carry out improvement strategies

  

• Unacceptable: cease activities and endorse immediate action