COVID-19 Workplace Risk Assessment V2 Checklist

• Title of Risk Assessment

• Date and Time of Risk Assessment

  Date

• Risk Assessment completed by:

• Date that this Risk Assessment need Reviewing (12 months time unless there is an Accident or Change in the Meantime)

  Date

Area / Work Process

• Area / Work Process

• Hazard

  Select

• Persons at Risk E P C O

  Select

• How might they be harmed?

  Select

• Specify Illness / Injury

• Current Control Measures (already in place)

  Select

• Detail Other control measures

Risk Rating H / M / L

• Enter Likelihood of Occurrence

  Select

• Enter Potential Severity

  Select

• Enter Risk Rating (Likelihood x Severity)

  LOW RISK

  MEDIUM RISK

  HIGH RISK

Additional Controls

• Additional Control Measures Required

  Select

• Specify Other Control measures required

• Enter Revised Risk Rating (After Additional Control Measures have been Completed)

  LOW RISK

  MEDIUM RISK

  HIGH RISK

• Estimated Date for Completion of Additional Control Measures

  Date

Area / Work Process

• Area / Work Process

• Hazard

  Select

• Persons at Risk E P C O

  Select

• How might they be harmed?

  Select

• Specify Illness / Injury

• Current Control Measures (already in place)

  Select

• Detail Other control measures

Risk Rating H / M / L

• Enter Likelihood of Occurrence

  Select

• Enter Potential Severity

  Select

• Enter Risk Rating (Likelihood x Severity)

  LOW RISK

  MEDIUM RISK

  HIGH RISK

Additional Controls

• Additional Control Measures Required

  Select

• Specify Other Control measures required

• Enter Revised Risk Rating (After Additional Control Measures have been Completed)

  LOW RISK

  MEDIUM RISK

  HIGH RISK

• Estimated Date for Completion of Additional Control Measures

  Date

Area / Work Process

• Area / Work Process

• Hazard

  Select

• Persons at Risk E P C O

  Select

• How might they be harmed?

  Select

• Specify Illness / Injury

• Current Control Measures (already in place)

  Select

• Detail Other control measures

Risk Rating H / M / L

• Enter Likelihood of Occurrence

  Select

• Enter Potential Severity

  Select

• Enter Risk Rating (Likelihood x Severity)

  LOW RISK

  MEDIUM RISK

  HIGH RISK

Additional Controls

• Additional Control Measures Required

  Select

• Specify Other Control measures required

• Enter Revised Risk Rating (After Additional Control Measures have been Completed)

  LOW RISK

  MEDIUM RISK

  HIGH RISK

• Estimated Date for Completion of Additional Control Measures

  Date

Area / Work Process

• Area / Work Process

• Hazard

  Select

• Persons at Risk E P C O

  Select

• How might they be harmed?

  Select

• Specify Illness / Injury

• Current Control Measures (already in place)

  Select

• Detail Other control measures

Risk Rating H / M / L

• Enter Likelihood of Occurrence

  Select

• Enter Potential Severity

  Select

• Enter Risk Rating (Likelihood x Severity)

  LOW RISK

  MEDIUM RISK

  HIGH RISK

Additional Controls

• Additional Control Measures Required

  Select

• Specify Other Control measures required

• Enter Revised Risk Rating (After Additional Control Measures have been Completed)

  LOW RISK

  MEDIUM RISK

  HIGH RISK

• Estimated Date for Completion of Additional Control Measures

  Date

Area / Work Process

• Area / Work Process

• Hazard

  Select

• Persons at Risk E P C O

  Select

• How might they be harmed?

  Select

• Specify Illness / Injury

• Current Control Measures (already in place)

  Select

• Detail Other control measures

Risk Rating H / M / L

• Enter Likelihood of Occurrence

  Select

• Enter Potential Severity

  Select

• Enter Risk Rating (Likelihood x Severity)

  LOW RISK

  MEDIUM RISK

  HIGH RISK

Additional Controls

• Additional Control Measures Required

  Select

• Specify Other Control measures required

• Enter Revised Risk Rating (After Additional Control Measures have been Completed)

  LOW RISK

  MEDIUM RISK

  HIGH RISK

• Estimated Date for Completion of Additional Control Measures

  Date