Workplace Risk Assessment

• Location of the Workplace

  Select

• Prepared on

  Date

• Prepared by

  Sign

• What is being Risk Assessed?

Focus of the Workplace Risk Assessment

Goal of the Workplace Risk Assessment

• Why is this workplace risk assessment needed?

• What is the intended result, effect, or output of this workplace risk assessment?

Scope of the Workplace Risk Assessment

• What's included in this workplace risk assessment?

• What's not included in this workplace risk assessment?

Important Details Regarding the Workplace Risk Assessment

• Who will be involved in this workplace risk assessment and what level of responsibility or participation do they have?

• Where (specific room, site, facility, building, or area) will this workplace risk assessment be performed?

• To begin the workplace risk assessment, select the "+" icon next to Hazard:

Hazard

• Description of hazard

• Photo of the hazard (optional)

  Media

• Risk related to hazard

• Who might be harmed?

• Risk likelihood

  Very Likely

  Likely

  Unlikely

  Highly Unlikely

• Risk consequences

  Fatality

  Major Injury

  Minor Injury

  Negligible Injury

• Use this risk matrix to identify the risk level:

  

• Risk level

  High

  Medium

  Low

• Hazard causing risk can be eliminated?

  Yes

  No

  N/A

• Are you already doing something to control this risk (existing risk control measure)?

  Yes

  No

  N/A

• Develop a risk control measure targeting this risk.

  Compliant

  Non-Compliant

  N/A

• What additional controls could be implemented?

• Briefly describe the existing control measure:

• Further action needed to control the risk?

  Yes

  No

  Unsure

• Select the "Action" icon to create an action, assign it to someone, and set a due date.

  Compliant

  Non-Compliant

  N/A

• Eliminate the hazard causing the risk.

• Are you already doing something to control this risk (existing risk control measure)?

  Yes

  No

  N/A

• Briefly describe the existing control measure:

• Further action needed to control the risk?

  Yes

  No

  Unsure

• Select the "Action" icon to create an action, assign it to someone, and set a due date.

  Compliant

  Non-Compliant

  N/A

• Further action needed to control the risk?

  Yes

  No

  Unsure

• Select the "Action" icon to create an action, assign it to someone, and set a due date.

  Compliant

  Non-Compliant

  N/A

• Monitor this risk.

  Compliant

  Non-Compliant

  N/A

• To ADD another hazard to the workplace risk assessment, select the "+" icon next to Hazard.
  To END the workplace risk assessment, select the "Next Page >" button at the bottom right.

• What risk control measures have you developed?

• How will you monitor the effectiveness of these risk control measures?

• How often will you review this workplace risk assessment?

  Select Every 2 weeks Every month Every 3 months Every 6 months Every year Every 15 months

  • Every 2 weeks
  • Every month
  • Every 3 months
  • Every 6 months
  • Every year
  • Every 15 months

• The HSE recommends reviewing workplace risk assessments at least annually.

  Pass

  Fail

  N/A

• Name and Signature of Employer/Owner/Manager of Workplace

  Sign

• Did the employer/owner/manager of the workplace perform the workplace risk assessment himself/herself?

  Yes

  No

  Unsure

• Name and Signature of Appointed Person

  Sign