RISK ASSESSMENT FORM (UNFINISHED)

RISK ASSESSMENT FORM
Shoot date		Production Title		Page            of
21/03/2016		Photography Studio		1/4
		Producer
		Quiarna Brewster

                                                           

Location:
Address:

RATINGS:

·       each risks severity on scale from Negligable (N), Low risk (L), Moderate risk (M), Severe (S), Very severe (V)

·       each risks likelihood on scale from Very unlikely (VU), Unlikely (U), Possible (P), Likely (L), Very likely (VL)

·       risk factor from the table overleaf.

Hazard		Present?	Severity	Likelihood	Risk Factor
1	Alcohol/drugs	No	N	VU	0
2	Animals/insects	No	N	VU	0
3	Audiences	No	L	P	1
4	Camera cable/grip equipment	Yes	M	L	3
5	Confined spaces	Yes	M	L	2
6	Derelict buildings/dangerous structures	No	N	VU	0
7	Electricity/gas (other than normal supplies)	No	N	VU	0
8	Fatigue/long hours	No	N	VU	0
9	Fire/flammable materials	Yes	M	P	4
10	Hazardous substances	No	N	VU	0
11	Heat/Cold/extreme weather	No	N	VU	0
12	Laser/strobe effects	Yes	L	P	2
13	Machinery/industrial/ crane/hoist	No	N	VU	0
14	Materials - glass, non-fire retardant set materials	No	N	VU	0
15	Night operation	No	N	VU	0
16	Noise – high sound levels	No	N	VU	0
17	Non standard manual handling	No	N	VU	0
18	Public/crowds	No	N	VU	0
19	Radiation	No	N	VU	0
20	Scaffold/Rostra	No	N	VU	0
21	Smoking on set	No	N	VU	0
22	Special effects/explosives	No	N	VU	0
23	Special needs (elderly, disabled, inexperienced)	No	N	VU	0
24	Specialised rescue/first aid	No	N	VU	0
25	Stunts, dangerous activities	No	N	VU	0
26	Tall scenery/suspended ceilings	No	N	VU	0
27	Vehicles/speed	No	N	VU	0
28	Water/proximity to water	No	N	VU	0
29	Weapons	No	N	VU	0
30	Working at heights	No	N	VU	0
31	Working overseas	No	N	VU	0
32	Other risks	No	N	VU	0

Calculate the Risk Factor:

	Very Unlikely	Unlikely	Possible	Likely	Very Likely
Very severe	3	4	4	5	5
Severe	2	3	3	3	5
Moderate	2	2	3	3	3
Low	1	2	2	3	3
Negligible	1	1	2	2	3

Decide the action to take:

5	Very severe	Take immediate action
4	Severe	High priority
3	Moderate Risk	Programme for action
2	Low Risk	Action may be required
1	Negligible	Probably acceptable

Then list each risk identified

Hazard no:
Description
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )
Action to take
Person/company responsible for action
To be completed at agreed later date
Exposed person(s) informed? (y/n)		Agreed action taken? (y/n)			Risk removed? (y/n)

Hazard no:			Risk Factor (1-5):
Description
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )
Action to take
Person/company responsible for action
To be completed at agreed later date
Exposed person(s) informed? (y/n)		Agreed action taken? (y/n)			Risk removed? (y/n)
Hazard no:			Risk Factor (1-5):
Description
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )
Action to take
Person/company responsible for action
To be completed at agreed later date
Exposed person(s) informed? (y/n)		Agreed action taken? (y/n)			Risk removed? (y/n)

Hazard no:			Risk Factor (1-5):
Description
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )
Action to take
Person/company responsible for action
To be completed at agreed later date
Exposed person(s) informed? (y/n)		Agreed action taken? (y/n)			Risk removed? (y/n)

Hazard no: 11			Risk Factor (1-5):
Description
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )
Action to take
Person/company responsible for action
To be completed at agreed later date
Exposed person(s) informed? (y/n)		Agreed action taken? (y/n)			Risk removed? (y/n)

Hazard no:			Risk Factor (1-5):
Description
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )
Action to take
Person/company responsible for action
To be completed at agreed later date
Exposed person(s) informed? (y/n)		Agreed action taken? (y/n)			Risk removed? (y/n)

Hazard no: 30			Risk Factor (1-5):
Description
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )
Action to take
Person/company responsible for action
To be completed at agreed later date
Exposed person(s) informed? (y/n)		Agreed action taken? (y/n)			Risk removed? (y/n)

Completed by:                                                             Position:

Signature                                                                     Date: