"Safety doesn't happen by accident... so let's take a moment to plan for it!"

  • Location
  • Customer Reference

  • Conducted on

  • Prepared by

  • Short Description of the Job example TRR/Cabling internal install Survey

Point of Work Risk Assessment- Part 1- Before you start Work

  • I declare that I am currently fit to undertake the tasks outlined in this risk assessment. I am not aware of any physical or mental health conditions that may impair my ability to work safely and effectively. I have not consumed any substances that may affect my judgment or coordination. All members of team to sign please.

  • Do you have the right tools for the job?

  • Are tools that you need in working order and in Calibration date?

  • Do you have the right documentation for the job?

  • Do you have the right PPE for the job? PPE minimum requirements are <br>HI-Vis<br>Safety Boots <br>Gloves<br>Hard Hat<br>Eye Protection <br>Trousers

  • Is equipment use for working at height inspected? Has it got an in date Tag?

  • If you have answered 'NO' to any of the above, take the required action or report it to the office.

Point of Work Risk Assessment- Part 2- Hazard Identification

  • IMPORTANT: If you tick a box, you MUST provide details in the "Notes" section about the additional control measures you will put in place before work begins. This ensures the hazard is properly managed.

    Example:

    ✅ [✓] Working at height (using a ladder)

    Notes:

    Hazard: Falling from height while accessing [location] using a ladder.
    Additional Controls:
    Ladder will be inspected for defects before use.
    Ladder will be secured at the top and base by [method].
    The area around the ladder will be cordoned off to prevent collisions.
    A second worker will be present to foot the ladder and provide assistance.
    Why this is important:

    This instruction emphasises the action required when a hazard is identified. It makes it clear that ticking "yes" means:

    Acknowledgement: You recognize the hazard and its potential risk.
    Responsibility: You are taking ownership of implementing necessary controls.
    Action: You will take specific steps to mitigate the risk before starting the work.
    This helps to ensure that the POWRA is not just a checklist exercise, but a proactive tool for managing workplace safety.

  • Slip, Trips or Falls

  • Falls from Height

  • Chemicals

  • Heat/Fire/Explosion

  • Asphyxiation

  • Asbestos

  • Manual Handling

  • Vehicles

  • Confined Space

  • Dust/Fumes

  • Noise/Vibration

  • Electricity

  • Poor Lighting

  • Adverse Weather

  • Risk to others from your work

  • Others (specify)

Operative Sign Off

  • This is a record of a point of work survey conducted for the above job: all control measures have been put into place before i started the job, all workers names to be listed

  • Name

  • Signature

  • Date & Time

End of Job Review

  • Has the work created any new hazards?

  • Comments

  • If you have answered YES to either of these questions, tell your Manager.

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.