Title Page
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Title of Risk Assessment
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Date and Time of Risk Assessment
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Risk Assessment completed by:
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Date that this Risk Assessment need Reviewing (12 months time unless there is an Accident or Change in the Meantime)
COVID-19 Workplace Risk Assessment
Area / Work Process
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Area / Work Process
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Hazard
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Persons at Risk E P C O
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How might they be harmed?
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Specify Illness / Injury
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Current Control Measures (already in place)
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Detail Other control measures
Risk Rating H / M / L
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Enter Likelihood of Occurrence
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Enter Potential Severity
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Enter Risk Rating (Likelihood x Severity)
Additional Controls
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Additional Control Measures Required
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Specify Other Control measures required
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Enter Revised Risk Rating (After Additional Control Measures have been Completed)
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Estimated Date for Completion of Additional Control Measures
COVID-19 Workplace Risk Assessment (Continued)
Area / Work Process
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Area / Work Process
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Hazard
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Persons at Risk E P C O
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How might they be harmed?
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Specify Illness / Injury
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Current Control Measures (already in place)
-
Detail Other control measures
Risk Rating H / M / L
-
Enter Likelihood of Occurrence
-
Enter Potential Severity
-
Enter Risk Rating (Likelihood x Severity)
Additional Controls
-
Additional Control Measures Required
-
Specify Other Control measures required
-
Enter Revised Risk Rating (After Additional Control Measures have been Completed)
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Estimated Date for Completion of Additional Control Measures
COVID-19 Workplace Risk Assessment (Continued)
Area / Work Process
-
Area / Work Process
-
Hazard
-
Persons at Risk E P C O
-
How might they be harmed?
-
Specify Illness / Injury
-
Current Control Measures (already in place)
-
Detail Other control measures
Risk Rating H / M / L
-
Enter Likelihood of Occurrence
-
Enter Potential Severity
-
Enter Risk Rating (Likelihood x Severity)
Additional Controls
-
Additional Control Measures Required
-
Specify Other Control measures required
-
Enter Revised Risk Rating (After Additional Control Measures have been Completed)
-
Estimated Date for Completion of Additional Control Measures
COVID-19 Workplace Risk Assessment (Continued)
Area / Work Process
-
Area / Work Process
-
Hazard
-
Persons at Risk E P C O
-
How might they be harmed?
-
Specify Illness / Injury
-
Current Control Measures (already in place)
-
Detail Other control measures
Risk Rating H / M / L
-
Enter Likelihood of Occurrence
-
Enter Potential Severity
-
Enter Risk Rating (Likelihood x Severity)
Additional Controls
-
Additional Control Measures Required
-
Specify Other Control measures required
-
Enter Revised Risk Rating (After Additional Control Measures have been Completed)
-
Estimated Date for Completion of Additional Control Measures
COVID-19 Workplace Risk Assessment (Continued)
Area / Work Process
-
Area / Work Process
-
Hazard
-
Persons at Risk E P C O
-
How might they be harmed?
-
Specify Illness / Injury
-
Current Control Measures (already in place)
-
Detail Other control measures
Risk Rating H / M / L
-
Enter Likelihood of Occurrence
-
Enter Potential Severity
-
Enter Risk Rating (Likelihood x Severity)
Additional Controls
-
Additional Control Measures Required
-
Specify Other Control measures required
-
Enter Revised Risk Rating (After Additional Control Measures have been Completed)
-
Estimated Date for Completion of Additional Control Measures