Information

  • Document No.

  • ID Category

  • Other ID Category

  • ID Number

  • Station

  • Conducted on

  • Prepared by

Event Assessment (1-5)

  • Event Category

  • 1: Accident with serious injries or fatalities; or significant damage to aircraft or property
    2: Serious incident with injuries and/or substantial damage to aircraft or property
    3: Incident with minor injury and/or minor aircraft or property damage
    4: Incident with less than minor injury and/or less than minor damage
    5: No relevant safety risk

  • Accident or Incident Assessment

  • 1: Fatality or serious injury with total disability/loss of capacity
    2: Immediate admission to hospital as an inpatient and/or partial disability/loss of capacity
    3: Injury requiring ongoing treatment, with no permanent disability/loss of capacity
    4: Minor injury not resulting in an absence
    5: No injury risk

  • Employee/Customer Injury Assessment

  • 1: Multiple aircraft OTS > 24 hours
    2: One aircraft OTS > 24 hours
    3: Aircraft OTS 2 to 24 hours
    4: Aircraft OTS < 2 hours
    5: No Aircraft OTS

  • Assets Assessment

  • 1: Loss of aircraft; beyond crew capability, operating with no meaningful safety margins
    2: Physical distress/high workload impairing the accuracy and completion of tasks
    3: Large reduction in safety margins; reduction in ability of crew to cope with adverse operating conditions
    4: Operation beyond operating limiations; use of abnormal procedures
    5: No effect on operational safety

  • Operational Events Assessment

  • 1: Returning an aircraft so service and operating it in a non-standard, unairworthy, or unsafe conditions
    2: Returning an aircraft to service and operating it in a non-standard but not unsafe condition
    3: Returning an aircraft to service in a non-standard condition, but not operating it
    4: Affecting aircraft or systems reliability above established control limits but no affect on airworthiness or the safe operation of the aircraft
    5: No effect on airworthiness

  • Airworthiness Assessment

  • 1: Extended negative national media coverage resulting in a substantial change in public opinion of Sun Country
    2: Short term negative media/internet activity resulting in minor change in public opinion of Sun Country
    3: Short term negative media/internet activity resulting in no change in public opinion of Sun Country
    4: Isolated negative media/internet activity resulting in no change in public opinion of Sun Country
    5: No negative media/internet activity

  • Brand Assessment

  • 1: Extreme Customer Dissatisfaction: More than 500 customers affected for 48 hours or more
    2: Customer Dissatisfaction: More than 500 customers affected for 3 to 48 hours
    3. Customer Annoyance: Less than 500 customers affected for 3 to 48 hours
    4: Isolated Customer Annoyance: Less than 500 customers affected for up to 3 hours
    5: No customer disruptions

  • Customer Assessment

  • 1: Severe Danger to Environment: Large, significant in waste of resources and emissions into water, air, or soil
    2: Medium significance in waste or resources and emissions into water, air, or soil
    3: Small significance in waste of resources and emissions into water, air, or soil
    4: Small waste or emission, no relevant risk of pollution
    5: No relevant risk of pollution, no spill but an undesirable situation

  • Environment Assessment

  • 1: Loss of aircraft or death of Sun Country employee due to successful attack, terrorist activity, or civil unrest
    2: Security threat is genuine. Situation can only be resolved by handling control to outside agencies
    3: Security threat is genuine. Situation is only mitigated/resolved with assistance of outside agencies
    4: Security threat is genuine but can be mitigated or resolved by Sun Country
    5: Security threat is a hoax

  • Security Assessment

  • 1: Major Regulatory Deviation: Loss of company approvals, permits or certificates, resulting in the suspension of all operations
    2: Moderate Regulatory Deviation: Loss of company approvals, permits or certificates, resulting in suspension in part of Sun Country operations
    3: Minor Regulatory Deviation: Major breach of company policy or SOP's with no direct impact on approvals, permits or certificates, with a significant negative effect of ability to mange operations. Attitude or regulatory authority towards Sun Country has been negatively impacted
    4: Policy/Procedure Deviation: Breach of company policy of SOP's, with no direct impact on approvals, certificates, permits, with a minor effect of ability to manage operations. Falls below industry "best practices"
    5: No breach of company requirements; No impact on approvals or permits

  • Regulatory Assessment

  • 1: Loss or breakdown of entire system, subsystem, or process
    2: Partial breakdown of a system, subsystem, or process
    3: System deficiencies leading to poor reliability or disruption
    4: Little to no effect on system, subsystem, or process
    5: No impact on system, subsystem, or process

  • System or Process Assessment

  • 1: Safety of operations in doubt
    2: Non-compliance with company policy or CFR
    3: Non-conformance with company policy or CFR
    4: Audit observation
    5: No findings or observations

  • Audit Finding Assessment

  • 1: Willful
    2: Repeat
    3: Serious
    4: General/Other
    5: No breach of OSHA requirements

  • OSHA Assessment

Reactive/Proactive Assessment (A-D)

  • Use REACTIVE to classify the risk as it occurred in an event (ex: near miss, close call, quality escape, accident, incident, injury)

    Use PROACTIVE to classify the potential for risk to manifest itself in the system. This is forward looking assessment using safety assurance data to support the likelihood

  • Type of Assessment

  • What was the effectiveness of the remaining controls between this event and the most credible outcome?

  • A: Not Effective: Remaining controls were ineffective or no controls remained. The only thing preventing an accident were luck or exceptional skills, which is not trained or required
    B: Minimal: Some controls were left but their total effectiveness was minimal
    C: Limited: An abnormal situation, more demanding to manage, but with still a considerable remaining safety margin
    D: Effective: Consisting of several good controls

  • Reactive Assessment (Control Effectiveness)

  • A: Likely to Occur: (Will occur in most circumstances, not surprised if it happens) or occurs > 1 in 100
    B: Possible to Occur: (Might occur in some circumstances) or occurs > 1 in 1,000
    C: Unlikely to Occur: (Could occur in some circumstances, surprised if it happens) or occurs in > 1 in 10,000
    D: Rare to Occur: (May occur but only in exceptional circumstances, may happen but it would only be highly unexpected) or occurs > 1 in 1,000,000

  • Proactive Assessment (Likelihood)

Overall Rating

  • Risk Matrix (for reference)

    Risk Matrix.png
  • Overall Assessment (use responses from above)

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.