SAFE-F-108 Risk Assessment Template

• What is being assessed?

• Affected work area:

• Location/Area of Work
  Address

• conducted on:

  Date

• Responsible supervisor/s

• Assessors

Participant

• Add signature

  Sign

• Instructions
  1. Identify Risk rating and preventive measures by answering the questions accordingly
  2. Add photos and notes by clicking on the paperclip icon
  3. To add a Corrective Action and Control measures to minimize risk, click on the paperclip icon then "Add Action," provide a description, assign to a member, set priority, and due date
  4. Complete audit by providing digital signature
  5. Share your report by exporting as PDF, Word, Excel or Web Link
  
  Control Measures – List below the control measures to minimize risk
  

Identify the activity.location and persons at risk

• Activity or process

• Location
  Address

• Identify who may be at risk This may include fellow workers, visitors, contractors and the public Persons at risk

• Risk assessment team (Who was consulted?)

• List of Legislation, Code of Practice, Australian Standards, Guidance Materials used to determine control measures

•Control Measure

• Specify and provide details

Risk Assessment Methodology

• Most activities or processes are broken down into a variety of separate tasks. For each task, consider the hazards, the potential harm or negative outcomes and the conditions required for those negative outcomes to occur.
  
  Whenever assessing the health and safety risks associated with a task, always consider the following primary risk factors.
  • The physical activities required to complete the task e.g. repetitive movement, high force, physical exertion, awkward posture
  • The work environment e.g. lighting, work layout, traffic, thermal comfort, working in isolation
  • The nature of the hazard itself e.g. working with chemicals, microorganisms, radiation, machinery, potentially violent clients
  • The individual workers involved, e.g. level of training, skills, experience, health, age, physical capacity
  A minimum of a Safe Work Procedure should be created for all tasks. Operators need to be deemed competent in all elements of the task they are required to perform.

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• Risk Identification – Using the risk matrix tables above, list below the identified risks
  Click +Add to begin

•Task

• Specify Task.Scenario

• Hazards

• Associated harm, e.g. what could go wrong?

• Existing Risk Controls

• Current risk rating<br>Use the Risk Matrix<br>

  High

  Medium

  Low

• Any additional controls are required or to improve process

• Residual risk rating<br>Use the Risk Matrix

  High

  Medium

  Low

• List emergency controls for how to deal with fires, spills, or exposure to hazardous substances and/or emergency shutdown procedures

Signatory

• Prepared By: (Full Name and Signature)

  Sign