Information

  • Risk Assessment No

  • Name of Expectant mother

  • Position Held by Expectant Mother

  • Expected Birth Date

  • Risk Assessment Conducted on

  • Name of the Person creating this Risk Assessment

1 - JOB DESCRIPTION (any additional tasks undertaken)

  • Brief Description of the work undertaken

  • Are you a first aider:-

  • Risk Rating from the answer to this question (0-6 Low.......7-11 Medium.......12-20 High)

  • If YES, to reduce the risk they must stand down and withdraw first aid support until their return after the birth.

  • Are you a Fire Warden:-

  • Risk Rating from the answer to this question (0-6 Low.......7-11 Medium.......12-20 High)

  • If YES, to reduce the risk they must stand down and withdraw from the role of fire warden until their return after the birth.

2 - PHYSICAL JOB DEMANDS - Does the work involve?

  • Do you Lift, Carry, or Push heavy objects as part of your role here ?:-

  • Risk Rating from the answer to this question (0-6 Low.......7-11 Medium.......12-20 High)

  • If YES to the above, to reduce the risk advise employee to avoid manual handling activities were the load is over 5kg, also to avoid lifting above shoulder or below knee height

  • Does the role require you to Stand for long periods? :-

  • If YES to the above, to reduce the risk advise employee to take regular breaks and sit when ever possible

  • Does your role require you to sit for long periods? :-

  • If YES to the above, to reduce the risk advise employee to take regular breaks and stand / move around when ever possible

  • Is shift / lone working required? :-

  • Risk Rating from the answer to this question (0-6 Low.......7-11 Medium.......12-20 High)

  • If YES to the above, advise her / her manager to change her role until after the birth

  • Do you drive or fly for the business? :-

  • Risk Rating from the answer to this question (0-6 Low.......7-11 Medium.......12-20 High)

  • If YES to the above, advise her to seek advice from her doctor/midwife and to discuss this advice with her manager so appropriate changes can be made to her work and further travel until after the birth.

  • Do you work from home as part of your job role? :-

  • Risk Rating from the answer to this question (0-6 Low.......7-11 Medium.......12-20 High)

  • If YES to the above, Ask her to describe her work area, it location, its safety and the equipment she has at home.

3 - WELFARE

  • Are toilet facilities easily accessible to the expectant mother?

  • If no to above please note - advise them to allow extra time to get to the toilet

  • Breaks:- Do you have access to make a hot drink and consume food?

  • If no assess the number of hours worked and if required arrange for a suitable staff room to be used

4 - SPECIFIC HAZARDS - Will the expectant mother be exposed to?

  • Are the floors generally dry and in good condition in the area of work?

  • Risk Rating from the answer to this question (0-6 Low.......7-11 Medium.......12-20 High)

  • If NO to the above advise them to wear suitable/sensible shoes and take extra care at all times

  • Are you continually exposed to high noise levels in her place of work? Possibly

  • Risk Rating from the answer to this question (0-6 Low.......7-11 Medium.......12-20 High)

  • Are you exposed to vibration, shock or movement?

  • Risk Rating from the answer to this question (0-6 Low.......7-11 Medium.......12-20 High)

  • If YES to the above, the employee may need to be redesigned to another area/department

  • If YES to the above, the employee is to be supplied with suitable hearing protection

  • Are you exposed to Harmful Substances?

  • Risk Rating from the answer to this question (0-6 Low.......7-11 Medium.......12-20 High)

  • If YES to the above, advise her not to use or be exposed to the hazardous substances until after the birth

  • Are they exposed to violence?

  • Risk Rating from the answer to this question (0-6 Low.......7-11 Medium.......12-20 High)

  • If YES to the above, advise her to stay behind her counter/desk or walk away and seek safety with her manager, team, stewards and not to put herself in danger at any time.

5 - ACCESS & EGRESS

  • Is Access to or from the location of work at AVFC an issue?

  • Risk Rating from the answer to this question (0-6 Low.......7-11 Medium.......12-20 High)

  • If YES to the above advise them on the safest / best routes

  • Are the floor coverings or the condition of the floors, steps, stairs etc a safety concern?

  • Risk Rating from the answer to this question (0-6 Low.......7-11 Medium.......12-20 High)

  • If YES to the above advise them on the safest / best routes to avoid hazardous areas

6 - OUTPUT RESULTS FROM ABOVE RISK ASSESSMENT

  • From the information so far should she see her Doctor or Midwife to ascertain information required in connection with the details within the risk assessment? If YES then list the issue and the owner.

  • ***Please schedule next review date with Expectant Mother (approx 12 weeks from today's date)***

  • Select date

  • Recommendations & Comments

7. Risk Rating

  • Risk Rating from the information given during this assessment and before any advice given or action implemented (0-6 Low..............7-11 Medium.......12-20 High)

  • What is the risk rating prior to this assessment?

  • Risk Rating once the advice, information & instruction has been given (0-6 Low..........7-11 Medium.......12-20 High)

  • What is the risk rating following this assessment?

7 - DISCLAIMER

  • ***I can confirm I have read and understood the above document. I can also confirm that if I experience any issues at all such as discomfort, pain etc. I will inform my Line Manager immediately.***

  • Expectant Mother Signature

  • Person carrying out this assessment's Signature

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