Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Section 1

  • Site

  • Location

  • Reported by

  • Reported to

  • Select date

  • Description of hazard

  • Risks posed by hazard

  • Legislative Reference

  • Current controls

  • Interim actions

  • Who has been Consulted?

  • Section 2
    Risk potential- risk analysis-risk calculator including current controls

  • Consequence(c)<br>Severity of injury/illness

  • Exposure (E)<br>(Frequency & duration)

  • Probability<br>(Likelihood of C+E)

  • Total (Consequence X Exposure X Probability)

  • Section 3

  • Possible Controls

  • Risk control plan (Preferred controls)

  • By whom

  • By when

  • Completed date

  • Completed (Sign off)

  • Any legislative requirements ?

  • Safety Alert required

  • Residual risk priority (Consequence X Exposure X Probability)

  • Section 4

  • Originator notified of action taken (Completed-sign off)

  • Date of sign off

  • Controls monitored for their completion,effectiveness and do not introduce any further risk (Completed-sign off)

  • Date of sign off

  • Record filed and database updated (Completed-sign off)

  • Date of sign off

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.