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Risk Assessment Form –
Part A
ProductionName:Sunderland
College Sunderlanddocumentary
Organisation Sunderland vpa
ProductionAddress:Sunderland
College
Producer / Editor
Tel:
Mobile:
Josh Matthew Daniel contacts are been
shared
Start date End date
Distribution Everyone from the
team uploadedto my blog
Who gets a copyof the assessment
Team
Outline of risk assessment
Summary of what is proposed in
terms of sequences and set ups.
Making a documentary using already creative material the issue is if w e sellit online or publish it somew here
/YouTube w e w illget in trouble but for college w illbe good.
Could be a riskof certain shots and also have to be carefulthat w e don’t get knocked over by a car and also
need permission to film in public or private properties.
Some people might not like to be filmed and also try not to film people.
Weather also could be a problem as if its raining the equipment might get damaged.
Team members / experts /
contractors / contributors etc.
List those involved
Josh Mathew Daniel
Eddie
Locations
Outline locationsinvolved – indicate
any which are hostile environments
Queen Alex Bridge Glass Center City Center
Assessor Name
Signature
Daniel Date completed
Authoriser Name
(if not Assessor) Signature
Date authorised
Hazard list – select your hazards from the list belowand use these to complete Part B
Situational hazards Tick Physical / chemical hazards Tick Health hazards Tick
Assault by person  Contact with cold liquid / v apour Disease causativ e agent
Attack by animal  Contact with cold surf ace  Inf ection 
Breathing compressed gas Contact with hot liquid / v apour Allergic reaction
Cold env ironment  Contact with hot surf ace  Lack of f ood / water
Crush by load Electric shock Lack of oxy gen
Drowning  Explosiv e blast Phy sical f atigue
Entanglement in mov ing machinery Explosiv e release of stored pressure Repetitiv e action
High atmospheric pressure Fire  Static body posture
Hot env ironment Hazardous substance Stress / anxiety 
Manual handling Ionizing radiation Venom poisoning
Object f alling, mov ing or f ly ing  Laser light
Obstruction / exposed f eature Lightning strike Environmental hazards
Sharp object / material  Noise  Litter 
Shot by f irearm  Non-ionizing radiation Nuisance noise / v ibration 
Slippery surf ace  Stroboscopic light Phy sical damage 
Trap in mov ing machinery Vibration Waste substance released into air
Trip hazard  Waste substance released into soil / water
Vehicle impact / collision  Managerial / organisational hazards
Falls f rom height  Management f actors (lack of communication,
co-operation, co-ordination and competence)
Risk matrix – use this to determine risk for
each hazard i.e. ‘how bad and how likely’ Likelihood of Harm
Severity of Harm
Remote
e.g. <1 in 1000 chance
Very unlikely
e.g. 1 in 200 chance
Unlikely
e.g. 1 in 50 chance
Possible
e.g. 1 in 10 chance
Likely
e.g. >1 in 3 chance
Negligible e.g. small bruise Trivial Trivial Trivial Low Low
Slight e.g. small cut, deep bruise Trivial Trivial Low Low Medium
Moderate e.g. deep cut, torn muscle Trivial Low Medium Medium High
Severe e.g. fracture, loss of consciousness Low Medium High High Extremely high
Very Severe e.g. death, permanent disability Low Medium High Extremely high Extremely high
Risk Assessment Form – Part B
Activity1
– Each individual activity you are proposing: Location – w here this activity willtake place: Dates / times:
Hazards2
List what could cause harm f rom this activ ity
e.g. falls from height, trip hazard, fire, etc.
Who exposed
List who might be harmed
f rom this activ ity
e.g. staff, contractors,
contributors, public, etc.
Risk3
For each hazard, decide
lev el of risk as if y ou were to
do the activ ity without y our
controls
Control measures
For each hazard, list the measures y ou will be taking to minimise the risk identif ied
e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective
equipment, provision of first aid, etc.
Risk3
For each hazard,
decide lev el of risk
once all y our controls
are in place
Falling in the river Daniel Matthew Josh
High risk
Be carefulw hen near water and make sure there is nothing to trip over. Low
Object f alling, mov ing or f ly ing
Daniel Josh Matthew Medium Watch out for falling objects Trivial
Daniel Josh Matthew High Look for fire exits In case of entrapment Low
Fire
Trip hazards Daniel Josh Matthew High Don’t slip over and w atch out do stickto the foot paths Low
Continue on separate sheet if necessary
1 – complete separate table for each activity 2 - from hazard list in Part A 3 - from risk matrix in Part A

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Risk assessment template.doc gilly

  • 1. Risk Assessment Form – Part A ProductionName:Sunderland College Sunderlanddocumentary Organisation Sunderland vpa ProductionAddress:Sunderland College Producer / Editor Tel: Mobile: Josh Matthew Daniel contacts are been shared Start date End date Distribution Everyone from the team uploadedto my blog Who gets a copyof the assessment Team Outline of risk assessment Summary of what is proposed in terms of sequences and set ups. Making a documentary using already creative material the issue is if w e sellit online or publish it somew here /YouTube w e w illget in trouble but for college w illbe good. Could be a riskof certain shots and also have to be carefulthat w e don’t get knocked over by a car and also need permission to film in public or private properties. Some people might not like to be filmed and also try not to film people. Weather also could be a problem as if its raining the equipment might get damaged. Team members / experts / contractors / contributors etc. List those involved Josh Mathew Daniel Eddie Locations Outline locationsinvolved – indicate any which are hostile environments Queen Alex Bridge Glass Center City Center Assessor Name Signature Daniel Date completed Authoriser Name (if not Assessor) Signature Date authorised Hazard list – select your hazards from the list belowand use these to complete Part B Situational hazards Tick Physical / chemical hazards Tick Health hazards Tick Assault by person  Contact with cold liquid / v apour Disease causativ e agent Attack by animal  Contact with cold surf ace  Inf ection  Breathing compressed gas Contact with hot liquid / v apour Allergic reaction Cold env ironment  Contact with hot surf ace  Lack of f ood / water Crush by load Electric shock Lack of oxy gen Drowning  Explosiv e blast Phy sical f atigue Entanglement in mov ing machinery Explosiv e release of stored pressure Repetitiv e action High atmospheric pressure Fire  Static body posture Hot env ironment Hazardous substance Stress / anxiety 
  • 2. Manual handling Ionizing radiation Venom poisoning Object f alling, mov ing or f ly ing  Laser light Obstruction / exposed f eature Lightning strike Environmental hazards Sharp object / material  Noise  Litter  Shot by f irearm  Non-ionizing radiation Nuisance noise / v ibration  Slippery surf ace  Stroboscopic light Phy sical damage  Trap in mov ing machinery Vibration Waste substance released into air Trip hazard  Waste substance released into soil / water Vehicle impact / collision  Managerial / organisational hazards Falls f rom height  Management f actors (lack of communication, co-operation, co-ordination and competence) Risk matrix – use this to determine risk for each hazard i.e. ‘how bad and how likely’ Likelihood of Harm Severity of Harm Remote e.g. <1 in 1000 chance Very unlikely e.g. 1 in 200 chance Unlikely e.g. 1 in 50 chance Possible e.g. 1 in 10 chance Likely e.g. >1 in 3 chance Negligible e.g. small bruise Trivial Trivial Trivial Low Low Slight e.g. small cut, deep bruise Trivial Trivial Low Low Medium Moderate e.g. deep cut, torn muscle Trivial Low Medium Medium High Severe e.g. fracture, loss of consciousness Low Medium High High Extremely high Very Severe e.g. death, permanent disability Low Medium High Extremely high Extremely high Risk Assessment Form – Part B Activity1 – Each individual activity you are proposing: Location – w here this activity willtake place: Dates / times: Hazards2 List what could cause harm f rom this activ ity e.g. falls from height, trip hazard, fire, etc. Who exposed List who might be harmed f rom this activ ity e.g. staff, contractors, contributors, public, etc. Risk3 For each hazard, decide lev el of risk as if y ou were to do the activ ity without y our controls Control measures For each hazard, list the measures y ou will be taking to minimise the risk identif ied e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective equipment, provision of first aid, etc. Risk3 For each hazard, decide lev el of risk once all y our controls are in place Falling in the river Daniel Matthew Josh High risk Be carefulw hen near water and make sure there is nothing to trip over. Low Object f alling, mov ing or f ly ing Daniel Josh Matthew Medium Watch out for falling objects Trivial Daniel Josh Matthew High Look for fire exits In case of entrapment Low
  • 3. Fire Trip hazards Daniel Josh Matthew High Don’t slip over and w atch out do stickto the foot paths Low Continue on separate sheet if necessary 1 – complete separate table for each activity 2 - from hazard list in Part A 3 - from risk matrix in Part A