Title Page

  • Location of the Workplace
  • Building

  • Prepared on

  • Prepared by

Focus of the Workplace Risk Assessment

Goal of the Workplace Risk Assessment

  • Why is this workplace risk assessment needed? (Other than being legally required)

  • How could this workplace risk assessment help your business and your employees?

  • 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?

  • When will this workplace risk assessment be performed?

Workplace Risk Assessment

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

  • Hazard
  • Photo of the hazard (optional)

  • Risk related to hazard

  • Who might be harmed?

  • Risk likelihood

  • Risk consequences

  • Use this risk matrix to identify the risk level:

    Risk Matrix SafetyCulture.png
  • Risk level

  • Hazard causing risk can be eliminated?

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

  • Please create a risk control action

  • Briefly describe the existing control measure:

  • Further action needed to control the risk?

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

  • Eliminate the hazard causing the risk.

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

  • Briefly describe the existing control measure:

  • Further action needed to control the risk?

  • Please create a risk control action

  • Further action needed to control the risk?

  • Please create a risk control action

  • Monitor this risk.

  • 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.

Completion/Review

  • 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?

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

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

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

  • Name and Signature of Appointed Person

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.