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
|
No
| |||
2
|
Animals/insects
|
No
| |||
3
|
Audiences
|
No
| |||
4
|
Camera cable/grip equipment
|
Yes
|
M
|
P
|
3
|
5
|
Confined spaces
|
Yes
|
LR
|
U
|
2
|
6
|
Derelict buildings/dangerous structures
|
Yes
|
LR
|
U
|
2
|
7
|
Electricity/gas (other than normal supplies)
|
No
| |||
8
|
Fatigue/long hours
|
Yes
|
S
|
L
|
3
|
9
|
Fire/flammable materials
|
Yes
|
VS
|
P
|
4
|
10
|
Hazardous substances
|
No
| |||
11
|
Heat/Cold/extreme weather
|
No
| |||
12
|
Laser/strobe effects
|
No
| |||
13
|
Machinery/industrial/ crane/hoist
|
No
| |||
14
|
Materials - glass, non-fire retardant set materials
|
No
| |||
15
|
Night operation
|
Yes
|
LR
|
U
|
2
|
16
|
Noise – high sound levels
|
No
| |||
17
|
Non standard manual handling
|
No
| |||
18
|
Public/crowds
|
No
| |||
19
|
Radiation
|
No
| |||
20
|
Scaffold/Rostra
|
No
| |||
21
|
Smoking on set
|
No
| |||
22
|
Special effects/explosives
|
No
| |||
23
|
Special needs (elderly, disabled, inexperienced)
|
Yes
|
LR
|
P
|
2
|
24
|
Specialised rescue/first aid
|
No
| |||
25
|
Stunts, dangerous activities
|
No
| |||
26
|
Tall scenery/suspended ceilings
|
No
| |||
27
|
Vehicles/speed
|
No
| |||
28
|
Water/proximity to water
|
No
| |||
29
|
Weapons
|
No
| |||
30
|
Working at heights
|
No
| |||
31
|
Working overseas
|
No
| |||
32
|
Other risks
|
No
|
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:
|
Camera cable/grip equipment
|
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )
|
Anybody moving about regularly
|
Action to take:
|
Cover wires up with mats
|
Person/company responsible for action
|
Producer
|
Hazard Number:
| |
Description of Hazard:
|
Fatigue/long hours
|
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )
|
Anybody working late at night
|
Action to take:
|
Everybody must be well rested/Supply Coffee
|
Person/company responsible for action
|
Producer
|
Hazard Number:
| |
Description
|
Fire/flammable materials
|
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )
|
Everybody, Neighbours
|
Action to take:
|
Keep hot equipment away for flammable materials/Fire extinguisher
|
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)
|
y
|
Agreed action taken? (y/n)
|
y
|
Risk removed? (y/n)
|
y
|
Completed by: Position:
Signature Date:
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