RISK ASSESSMENT RECORDING FORM

Location or
Address: House, Stairs
Activity or
Situation: Photoshoot
(1)

Hazard

Date Assessment
Undertaken:
Review
Date: 05/01/16

Assessment undertaken
By: Chloe Peacock
Signature

Risk

(2) Who might be harmed and how?

(3) What controls exist to reduce

risk

(4) What action can be taken to

Falling down the stairs 3/2

Avoid using the stairs if this is

possible.

Dropping the equipment down the

stairs 1/3

Either the cast or the crew it

depends on who is closest to the
stairs.
No one would be harmed but the
equipment would be damaged.

The dog that is present in the house

could try to attack someone 2/1

Either the cast or the crew as the

dog could bite them

Keep the dog in a separate room

so that it cant get close.

Use a hand rail to go up and down

as this will lower the chance of
falling down.
Keep the equipment in the
protective cases to minimise the
chance of it breaking.
Get someone to take the dog
outside of the house for a walk so
that there is no chance it can get
to use why we take the pictures.

Keep the equipment away from the

stairs unless it is being used.

further reduce risk?

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 eg. 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