RISK ASSESSMENT RECORDING FORM

Location or Date Assessment Assessment undertaken

Address: Appleton The dingle, Dingle way Undertaken: 21/05/2018 By: Ruby Jones
Activity or Review Signature
Situation: Photoshoot Date:

(1) Hazard Risk (2) Who might be harmed and how? (3) What controls exist to reduce (4) What action can be taken
risk to further reduce risk?

B1 x Local community, people might not Only when there is no one about. Ask people who are walking by If
Field : Public asking us to delete the A1 = want to be shooting who are walking they wouldn’t mind have a
images 1 by. photography shoot

The model and myself, could trip Search the field for anything that Remove all possible trip hazards
Field : tripping over B3 x over and possibly sprain / hurt could possibly trip us over and make sure everything is safe
A1 = themselves before filming.
3

The models or photographer could Search the field for anything that If the field condition is bad don't
The stream: falling in B3 x possibly injure themselves badly the models or photographer could shoot near the river
A2 = depending on the state of the possibly injure themselves on. and
6 ground, and falling in the stream leading to falling

Field : trees, branches The models or photographer as they

could get hit and either cut Don’t film by trees in windy
themselves or have a concussion Test the area before use. weather.
depending where it hits
 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 (5) What action can be taken
risk to further reduce risk?

RISK RATING

a SEVERITY b LIKELIHOOD c FINAL SCORE RATING: what needs to be done

5 Dying or being permanently disabled
4 Serious injury/long term illness
3 Temporary disability/3 days off sick
2 Will need medical attention
5 Will almost certainly happen 16-25 Stop! Do not start activity again until risk is
controlled
4 Highly likely to happen 10-15 High risk level, High priority. Take action
straight away to control the risk
3 Not so likely 6-9 Medium risk level. Tighten up controls and
make a plan to do something about risk
2 Even less likely 3-5 Fairly low risk level. Low priority but keep
possible action in mind
1 Minor injury eg. Bruise, graze 1 Unlikely to happen at all 1-2 Low or trivial risk. No further action
required.

SO: a x b = c

Action Required Responsible Person Date for Completion