HSE Risk Assessment Checklist

Assessment

Hazard Identification

Enter description of procedure, task or worksite being assessed

Biological (e.g. hygiene, disease, infection)

Are there biological hazards observed?

Choose the type of hazard

Description of hazard

Add media

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Chemicals

Are there chemical hazards observed?

Choose the type of hazard

Description of hazard

Photo of hazard (optional)

Name of chemical(s) / Details

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Critical Incident

Are there critical hazards observed?

Choose type of hazard resulting in:

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Energy Systems

Are there energy system hazards observed?

Choose the type of hazard / incident or issues involving:

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Environment

Are there environment hazards observed?

Choose type of hazard

Sun exposure
Water (creek, river, beach, dam)
Sound / Noise
Animals / Insects
Storms / Weather
Temperature (heat, cold)
Other

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Facilities / Built Environment

Are there facilities / built environment hazards observed?

Choose type of hazard

Buildings and fixtures
Driveway / Paths
Workshops / Work rooms
Playground equipment
Furniture
Swimming pool
Other

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Machinery, Plant and Equipment

Are there machinery, plant and equipment hazards observed?

Choose type of hazard

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Manual Tasks / Ergonomics

Are there manual tasks / ergonomics hazards observed?

Choose type of hazard

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

People

Are there people hazards observed?

Choose type of hazard

Students
Staff
Parents
Physical
Psychological / Stress
Other

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Others

Are there any other hazards not listed above?

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

References

Risk Matrix Reference

Screen Shot 2018-05-21 at 11.14.28 am.png

Hierarchy of Controls Reference

OSH toolkit noise - hierachy of controls.jpg

Monitor and Review Controls

Are the planned control measures sufficient and effective in minimizing the level of risk?

Have there been any changes to the planned control measures?

Are further control measures required in future?

Completion

Recommendations

Full Name and Signature of the Inspector

HSE Risk Assessment Checklist

Created by: SafetyCulture Staff | Industry: General | Downloads: 540

Use this template to document a risk assessment to manage health and safety hazards in your workplace. Identify observed potential and existing hazards (e.g biological, chemical, energy, environment, etc.), assess the risk level (consequence, likelihood and risk ratings) and provide necessary control measures. Monitor and review planned control measures and advise if further measures are required. Lastly, provide overall recommendations to avoid and manage risk hazards.

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Assessment

Hazard Identification

Enter description of procedure, task or worksite being assessed

Biological (e.g. hygiene, disease, infection)

Are there biological hazards observed?

Choose the type of hazard

Description of hazard

Add media

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Chemicals

Are there chemical hazards observed?

Choose the type of hazard

Description of hazard

Photo of hazard (optional)

Name of chemical(s) / Details

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Critical Incident

Are there critical hazards observed?

Choose type of hazard resulting in:

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Energy Systems

Are there energy system hazards observed?

Choose the type of hazard / incident or issues involving:

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Environment

Are there environment hazards observed?

Choose type of hazard

Sun exposure
Water (creek, river, beach, dam)
Sound / Noise
Animals / Insects
Storms / Weather
Temperature (heat, cold)
Other

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Facilities / Built Environment

Are there facilities / built environment hazards observed?

Choose type of hazard

Buildings and fixtures
Driveway / Paths
Workshops / Work rooms
Playground equipment
Furniture
Swimming pool
Other

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Machinery, Plant and Equipment

Are there machinery, plant and equipment hazards observed?

Choose type of hazard

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Manual Tasks / Ergonomics

Are there manual tasks / ergonomics hazards observed?

Choose type of hazard

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

People

Are there people hazards observed?

Choose type of hazard

Students
Staff
Parents
Physical
Psychological / Stress
Other

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Others

Are there any other hazards not listed above?

Description of hazard

Photo of hazard (optional)

Risk rating

Consequence

Likelihood

Risk rating

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

References

Risk Matrix Reference

Hierarchy of Controls Reference

Monitor and Review Controls

Are the planned control measures sufficient and effective in minimizing the level of risk?

Have there been any changes to the planned control measures?

Are further control measures required in future?

Completion

Recommendations

Full Name and Signature of the Inspector

HSE Risk Assessment Checklist

HSE Risk Assessment Checklist

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