RISK ASSESSMENT RECORDING FORM

Location or
Address: Door way/step(s)
Activity or
Situation: Photoshoot
(1)

Hazard

Date Assessment
Undertaken: 23/01/16
Review
Date:
Risk

(2) Who might be harmed and how?

Assessment undertaken
By: Bailey Warburton
Signature
(3) What controls exist to reduce
risk

(4) What action can be taken

Be careful walking up and down

the stairs.

Dont walk up or down the stairs.

Falling down the steps

The model acting that theyre

leaving their house in a moderate
speed.

Fingers being stuck in the door as

closing it.

Tripping over a step.

The model / person closing the door. Close the door by the handle and
make sure that the hand Is
nowhere near the unsafe part of
the door.
The model who is having their photo
taken and acting as theyre walking
Walk down/up the stairs slowly,
down the stairs.
which will ensure that they will not
trip.

To further reduce risk?

Dont shut the door/keep the door

closed at all times.

Dont walk down stairs, just make

it look like it, for example act like
they are walking down the stairs
but not actually doing it.

1. List hazards something with the potential to cause harm here:

Seek to quantify the level of risk the likelihood of harm arising based on the number of persons affected, how often they are exposed to the hazard and the
severity of any consequence.
2. List groups of people who are especially at risk from the significant hazards which you have identified
3. List existing controls here or note where the information may be found
4. List the risks which are not adequately controlled and the action you will take. Have regard for the level of risk, the cost of any action and the benefit you expect to
gain.

(1)

Hazard

Risk

(2) Who might be harmed and how?

(3) What controls exist to reduce

risk

(5) What action can be taken

To further reduce risk?

RISK RATING
a SEVERITY

b LIKELIHOOD

c FINAL SCORE RATING: what needs to be done

Dying or being permanently disabled

Will almost certainly happen

Serious injury/long term illness

Highly likely to happen

Temporary disability/3 days off sick

Not so likely

Will need medical attention

Even less likely

Minor injury e.g. Bruise, graze

Unlikely to happen at all

16-25
Stop! Do not start activity again until risk
is controlled
10-15
High risk level, High priority. Take action
straight away to control the risk
6-9
Medium risk level. Tighten up controls
and make a plan to do something about risk
3-5
Fairly low risk level. Low priority but keep
possible action in mind
1-2
Low or trivial risk. No further action
required.

SO: a x b = c
Action Required

Responsible Person

Date for Completion