Highbury Risk Assessment

• Conducted on

  Date

• Prepared by

• Location
  Address

Work Activity

• Advise the work activity that appears to be a risk

• Enter details of activity

Hazards Identified

• List all the hazards identified in relation to the particular activity

• Take picture of hazard(s) if possible

  Media

Who might be harmed?

• Who can be harmed or affected by these risks?

  Staff

  Client/Visitors

  Everyone

Description

• Advise description of risks

Risk rating

• Severity

  Fatality

  Major Injuries

  Minor Injuries

  Negligible Injuries

• Probability of occurance

  Very Likely

  Likely

  Unlikely

  Highly Unlikely

• Risk rating

  High

  Medium

  Low

• Reference: Risk Matrix

Existing Measures

• Were there any existing measures in place to control this risk?

  Yes

  No

  N/A

• Please detail existing measures

Resolution

• Indicate if this risk can be controlled immediately or not

  Select Requires Additional attention / control Adequately Controlled Unknown Risk

  • Requires Additional attention / control
  • Adequately Controlled
  • Unknown Risk

Completion

• Risk assessment has been completed

  Yes

  No

  N/A

• Risks reported have been resolved and completed

  Yes

  No

  N/A

• Signature

  Sign