Information

  • Activity being assessed:

  • Location of activity:

  • Date assessment completed:

  • Assessment completed by:

Assessment overview

  • Section A - preliminary

  • Q1 - Do the activities involve a significant risk of injury?<br>If 'No', the assessment is complete. <br>If 'Yes' go to Q2.

  • Q2 - Can the activity be avoided / mechanised / automated at a reasonable cost?<br>If 'Yes' implement controls and no further assessment is required.<br>If 'No', complete the detailed assessment.

  • Section B - Overall assessment of activity risk level

  • Q3 - What is the overall assessment of risk of injury involved in this activity?

  • If the activity is assessed as 'No' or 'Low' risk, the assessment is complete and will require no further action at this time.

    If the activity is assessed as 'Med' or 'High' risk, the controls identified in the detailed assessment section should be implemented as soon as practicable.

    This assessment should be reviewed on a minimum annual basis or more regularly if persons, processes or working conditions change.

Detailed assessment

  • For each question, choose one option based on existing working methods and control measures. List new control measures in the comment section of each question. The comment box can be opened by tapping on the question.

    The level of risk and any required actions will be based upon the assessors judgement of the conditions that are in place at the time of the assessment. Input from operatives and others should be sought if required.

T - Task. Does the task involve?

  • Holding loads away from the body

  • Twisting of the body

  • Stooping

  • Reaching upwards

  • Large vertical movement

  • Long carrying distances

  • Pushing or pulling

  • Unpredictable movements the load

  • Repetitive handling or movement

  • Insufficient rest / recovery times

  • A work rate imposed by a process

I - Individual. Does the task?

  • Require unusual capacity

  • Present a hazard to those with a health problem

  • Present a hazard to those who are pregnant

  • Require any special information or training

L - Load. Is the load?

  • Heavy

  • Bulky

  • Difficult to grasp/hold

  • Unstable / Unpredictable

  • Intrinsically harmful (hot / cold / contain chemicals etc)

E - Environment. In the working area, are there?

  • Constraints on working posture

  • Poor floor conditions

  • Variations in floor levels - ramps / steps / stairs etc

  • Extreme conditions - hot / cold / humid areas

  • Strong air movements

  • Areas of poor lighting

  • Identified slip / trip / fall hazards

Other factors.

  • Does the task require any PPE?

  • Is movement hindered by clothing?

  • Any other relevant information

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.