Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
Threats
Reportable threat
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Which threat category are you reporting?
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Choose first the likelihood on a scale of 1-5, then the severity of the consequence from 1-5
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Likelihood (1-5) 1- rare 2- unlikely 3- possible 4- likely 5- almost certain
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Consequence (1-5) 1- negligible 2- minor 3- moderate 4- major 5- catastrophic
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Risk Score
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This is a negligible risk. Please complete the priority matrix below.
Priority Matrix
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Do you want to add a priority rating?
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Choose first the risk score on a scale of 1-5, then the existing controls from 1-5
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Confirm risk score from above 1- negligible
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Existing Controls (1-5) 1- strong 2- baseline 3- barely adequate 4- inadequate
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Priority Score
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This is a low priority. No need to further report it
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This constitutes a medium priority. Please attach a corrective action
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This is a high priority. A notification will be sent to [x person] upon inspection completion. Please provide a corrective action.
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This is a the highest priority. A notification has been sent to [x person] immediately. Please also provide a corrective action.
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This constitutes a low risk. Please attach a corrective action & complete the probability matrix.
Priority Matrix
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Do you want to add a priority rating?
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Choose first the risk score on a scale of 1-5, then the existing controls from 1-5
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Confirm risk score from above 2- low
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Existing Controls (1-4) 1- strong 2- baseline 3- barely adequate 4- inadequate
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Priority Score
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This is a low priority. No need to further report it
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This constitutes a medium priority. Please attach a corrective action
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This is a high priority. A notification will be sent to [x person] upon inspection completion. Please provide a corrective action.
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This is a the highest priority. A notification has been sent to [x person] immediately. Please also provide a corrective action.
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This is a moderate level risk. A notification will be sent to [x person] upon inspection completion. Please attach a corrective action & complete the probability matrix.
Priority Matrix
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Do you want to add a priority rating?
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Choose first the risk score on a scale of 1-5, then the existing controls from 1-5
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Confirm risk score from above 3- moderate
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Existing Controls (1-5) 1- strong 2- baseline 3- barely adequate 4- inadequate
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Priority Score
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This is a low priority. No need to further report it
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This constitutes a medium priority. Please attach a corrective action
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This is a high priority. A notification will be sent to [x person] upon inspection completion. Please provide a corrective action.
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This is a the highest priority. A notification has been sent to [x person] immediately. Please also provide a corrective action.
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This is a high level risk. A notification has been sent to [x person] immediately. Please also attach a corrective action & complete the probability matrix.
Priority Matrix
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Do you want to add a priority rating?
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Choose first the risk score on a scale of 1-5, then the existing controls from 1-5
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Confirm risk score from above 4- high
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Existing Controls (1-4) 1- strong 2- baseline 3- barely adequate 4- inadequate
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Priority Score
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This is a low priority. No need to further report it
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This constitutes a medium priority. Please attach a corrective action
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This is a high priority. A notification will be sent to [x person] upon inspection completion. Please provide a corrective action.
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This is a the highest priority. A notification has been sent to [x person] immediately. Please also provide a corrective action.
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This is a severe level risk. A notification has been sent to [x person] immediately. Please also attach a corrective action & complete the probability matrix.
Priority Matrix
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Do you want to add a priority rating?
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Choose first the risk score on a scale of 1-5, then the existing controls from 1-5
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Confirm risk score from above 5- severe/critical
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Existing Controls (1-4) 1- strong 2- baseline 3- barely adequate 4- inadequate
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Priority Score
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This is a low priority. No need to further report it
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This constitutes a medium priority. Please attach a corrective action
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This is a high priority. A notification will be sent to [x person] upon inspection completion. Please provide a corrective action.
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This is a the highest priority. A notification has been sent to [x person] immediately. Please also provide a corrective action.
Final Scores & Signature
Final risk & priority rating
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This repetition is important for data analysis purposes.
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Final Risk Rating
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Final Priority Rating
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Signature