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1. Risk Assessment Form –
Part A
ProductionName: Unsung (cold case) Organisation MA24
ProductionAddress: 11*********Road
25 Helmsley ct
Producer / Editor
Tel:
Mobile:
Molly Allen
** ***** *****60
Start date 26th
January 2020 End date 2nd
February 2020
Distribution
Who gets a copyof the assessment
Molly Allen
Outline of risk assessment
Summary of what is proposed in
terms of sequences and set ups.
I w illbe filming w ith tw o actorsin tw o locations, a nearby cemetery and a house’s living room. There w illbe 5
scenes in total. Because the cemetery is in public, there are more possible hazards.
Team members / experts /
contractors / contributors etc.
List those involved
Lauren Slater (Actor), JackGreen (Actor),Molly Allen (Actor).
Locations
Outline locationsinvolved – indicate
any which are hostile environments
Molly’s house (living room) – not a hostile environment.
Red house cemetery- Only minor risks, not particularly hostile.
Assessor Name
Signature
Molly Allen Date completed 20/01/2020
Authoriser Name
(if not Assessor) Signature
Molly Allen Date authorised 20/01/2020
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

2. Risk Assessment Form – Part B
Activity1
– Each individual activity you are proposing: filming in a cemetery and inside a living
room.
Location – w here this activity willtake place: Red house cemetery and Molly’s living room. 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
Assault by person in the cemetery. Actors, Producer. Unlikely Stay aw are of citizens passing through the cemetery, w e willavoid anyone w ho appears
dangerous. There w illalso be multiple mobile phones on hard to contact the police if
someone is visibly a risk to us.
Very unlikely
Collision w ith vehicles passing through
the cemetery.
Actors, Producer. Possible If w e are near the road/pathw aywhere vehicles passthrough, we willlooks in both directions
as w e travel.
Very unlikely
Cold environment in the cemetery from
January w eather.
Actors, Producer. Possible I w illensure that all personnelw ear the appropriate clothing to avoid getting too cold, I w ill
also make sure w e don’t spend extended periods of time in possibly dangerous
temperatures.
Trivial
Trip hazard. Actor, Producer. Unlikely I w illensure that all personnelare cautious of w here they walkand w hat is in front of them. Very unlikely
Object falling, moving or flying from
trees above or things surrounding.
Actor, Producer. Unlikely I w illmake sure all personnelare cautious of their surroundings, particularly avoiding
anything that looks like it could possibly fallor move.
Trivial
A knife prop, there could be injury. Actor. Possible To avoid the knife injuring the cast I w illcover the knife in a clear layer of cello tape around
the sharp edges. Furthermore, the actor w illonly be w alking w ith the prop knife held aw ay
fromthem. This w illbe constantly monitored, and I w illcarry the appropriate casing for
transporting it betw een shooting scenes.
Unlikely
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