1. V9 RISK ASSESSMENT
RISK IN REVIEW
ACTIVITY HAZARD H/M/L PRECAUTIONS PLACE DATE REVIEWER
Dancing Banging head on fence. L Keeping my distance while Yes
dancing.
Tripping. M Only head dance. Yes
Holding mug Hot drink – Hot mug. H Let the drink cool. Yes
Shaking rattle Hitting their self on the head. M Make sure the rattle keeps a Yes
distance.
Posing with the wedges Falling H Make sure she keeps balance and Yes
the floor it flat and safe.
Moving map around Paper cut H Use a laminated map. Yes
Please leave this section blank:
Risk Assessment checked by: Name ………………………………………………….. Signed …………………………………………………. Date ……………………
KEY: Activity : Describe the component part of your pursuit.
Hazard : List the things you anticipate might cause harm or the things associated with your activity that have the potential to cause harm. Consider the likely
harm.
Risk: Assess the risk as either H (High), M (Medium) or L (Low). When concluding your assessment consider all of the circumstances.
Precautions: Consider what you could do to minimise / negate the risk.
In Place: Will the precautionary measures be in place at the time of the activity?
Review Date: When would it be reasonable to review your assessment? Remember it might be whilst you are undertaking the activity.
Reviewer: Name of the person responsible for completing the risk assessment.
A copy of this form should be taken on the activity or visit by the Reviewer.
V9/PALL/sspi/reviewedOct2010