RISK ASSESSMENT FORM
Production
Name & Number -
Shoot
Dates -
Production
Manager -
Producer -
Guidance:
1.
Assess whether a hazard will be present, write YES
or NO. Then for each hazard that you
have said YES to do the following:
2.
Rate each risk on a Severity scale from Negligable (N), Low risk (L), Moderate risk
(M), Severe (S), Very severe (V)
3.
Rate each risks Likelihood
on scale from Very unlikely (VU), Unlikely (U), Possible (P), Likely (L), Very
likely (VL)
4.
Determine the Risk
Factor from the table overleaf.
P = Present / S
= Severity / L = Likelihood / R = Risk Factor
|
|
Hazard
|
P
|
S
|
L
|
R
|
|
1
|
Alcohol/drugs
|
YES
|
S
|
P
|
3
|
|
2
|
Animals/insects
|
Yes
|
L
|
U
|
|
|
3
|
Audiences
|
|
|
|
|
|
4
|
Camera cable/grip equipment
|
Yes
|
M
|
P
|
|
|
5
|
Confined spaces
|
|
|
|
|
|
6
|
Derelict buildings/dangerous structures
|
|
|
|
|
|
7
|
Electricity/gas (other than normal
supplies)
|
|
|
|
|
|
8
|
Fatigue/long hours
|
|
|
|
|
|
9
|
Fire/flammable materials
|
|
|
|
|
|
10
|
Hazardous substances
|
|
|
|
|
|
11
|
Heat/Cold/extreme weather
|
Yes
|
M
|
VU
|
|
|
12
|
Laser/strobe effects
|
|
|
|
|
|
13
|
Machinery/industrial/ crane/hoist
|
|
|
|
|
|
14
|
Materials - glass, non-fire retardant set
materials
|
|
|
|
|
|
15
|
Night operation
|
|
|
|
|
|
16
|
Noise – high sound levels
|
|
|
|
|
|
17
|
Non standard manual handling
|
|
|
|
|
|
18
|
Public/crowds
|
Yes
|
M
|
L
|
|
|
19
|
Radiation
|
|
|
|
|
|
20
|
Scaffold/Rostra
|
|
|
|
|
|
21
|
Smoking on set
|
|
|
|
|
|
22
|
Special effects/explosives
|
|
|
|
|
|
23
|
Special needs (elderly, disabled,
inexperienced)
|
|
|
|
|
|
24
|
Specialised rescue/first aid
|
|
|
|
|
|
25
|
Stunts, dangerous activities
|
|
|
|
|
|
26
|
Tall scenery/suspended ceilings
|
|
|
|
|
|
27
|
Vehicles/speed
|
|
|
|
|
|
28
|
Water/proximity to water
|
|
|
|
|
|
29
|
Weapons
|
|
|
|
|
|
30
|
Working at heights
|
|
|
|
|
|
31
|
Working overseas
|
|
|
|
|
|
32
|
Other risks
|
|
|
|
|
5. 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 Risk
|
1
|
2
|
2
|
3
|
3
|
|
Negligible
|
1
|
1
|
2
|
2
|
3
|
6. 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
|
7. Then list each
risk identified
|
Hazard Number:
|
|
|
Description of Hazard:
|
Cold weather
|
|
Person(s) exposed (detail if cast/crew (C),
outside company (O) or public (P) )
|
Crew and Cast
|
|
Action to take:
|
Provide warm
clothing
|
|
Person/company responsible for action
|
|
|
Hazard Number:
|
|
|
Description of Hazard:
|
|
|
Person(s) exposed (detail if cast/crew (C),
outside company (O) or public (P) )
|
|
|
Action to take:
|
|
|
Person/company responsible for action
|
|
|
Hazard Number:
|
|
|
Description
|
|
|
Person(s) exposed (detail if cast/crew (C),
outside company (O) or public (P) )
|
|
|
Action to take:
|
|
|
Person/company responsible for action
|
|
|
Hazard Number:
|
|
|
Description
|
|
|
Person(s) exposed (detail if cast/crew (C),
outside company (O) or public (P) )
|
|
|
Action to take:
|
|
|
Person/company responsible for action
|
|
|
Hazard Number:
|
|
|
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:
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