Information

  • Client / Site

  • Line / Equipment

  • Assessment Conducted by

  • Team Involved In Assessment

  • Additional Team Members

  • Conducted on

Purpose and Scope

  • Add media

  • Provide brief context and extent of risk assessment

Methodology

  • Documentation Review (notes & key findings)
    (Includes previous risk assessments, incident trends, hazard registers, design reviews)

  • Observations and Interviews with Operators (notes & key findings)

  • Add media

  • Add drawing

Assessment

  • Work Action, Load, repetition, duration

  • Add media

  • Equipment (includes lifting, handling, moving equipment & tools)

  • Add media

  • Environment (includes physical, workstation, noise, humidity, lighting, layout etc)

  • Add media

  • Systems (includes procedures, roster, rotation, planning, fatigue)

  • Add media

  • ADD RISKS
  • Risk Factor Identified

  • Add media

  • Risk likelihood ( how likely is it to occur)

  • Potential Consequence (How severely could it harm a person or the environment?)

  • Risk Matrix
  • Risk Score

  • Current controls in place

  • Recommendation and responsible person.

  • New Risk likelihood ( how likely is it to occur)

  • New Potential Consequence (How severely could it harm a person or the environment?)

  • New Risk Score

  • Control

Signoffs

  • Add signature

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.