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Risk Assessment Form – Part A

Reference:

Sign-off status

None required

Blank Template

[planning/approved etc]

Assessment summary details
Assessment title *
(Simple name for reference
purposes)
Division:*

If I were a boy music video

Department:*

Production

Series/ Prod/Unit:
Responsible Manager:

Programme/Area:

Thea de Chavez
11 Hamden Way

Address/Tel:

Media

Contact office:
Address/Tel:

CB23 3UG

Netherhall School and Sixthform
Centre
Queen Ediths Way
CB1 8NN
01223242931

Date assessment created

21/10/2013

Assessment Outline
(Summary of what is
proposed)

The filming of a music video, to check that the location is safe to use

Confidential risk
assessment?

NO

Assessment start date

28/10/13

Country location

England

Hostile / travel
advisory?

Location details

1 Collingwood Drive
Longstanton Cambridge

NB: If the country location selected is ‘Hostile’ you are
required to: complete the BBC Overseas High Risk
Assessment Form

Crew / team
(Roles, responsibilities,
competencies)

Review / End date

01/11/13
N/A

Thea de Chavez – Camerawork and Director

Attachments
(Detail supporting
documents)
Assessor(s)

*

Thea de Chavez

(Person drafting risk
assessment)
Authoriser(s) *
(Person responsible for
sign-off)
Distribution
(Who gets a copy of the
assessment)

Assessor safety
competence

Date signed-off *
Mr Sheppard
Production Crew
Data Protection Act: Personal information collected for the purposes of risk assessment will be used to identify those at risk, and
those involved in controlling risk, from this or similar activities and to fulfil the BBC's obligations under Health and Safety policy and
legislation. It will be retained for up to 6 years after the expiry of the activity. It may be shared with other organisations, including
our agents and contractors, with whom the risk or the control of risk is shared.

Activity and Hazard Summary

[This is a summary of the activities listed in part B of the risk assessment.]

Activity

Who Exposed

Hazards{hazard titles

Filming on stair, park

Cast and Crew

Possibility of tripping and
falling

[* mandatory fields]

Activity Risk Rating
LOW
Risk Assessment Form – Part A

Blank Template

Comments log
Who by

Date / time
received

Comments

Assessor response

Date/ time
responded

Risk Assessment
Form – Part B
Reference:

[enter reference number]]

6

ACTIVITIES:
What are you doing, where, for how long and who will be involved?
Complete the fields in the form below).
Activity Title:*

Filming on stairs – someone might trip/fall
Park – They could hurt themselves

List those managing
this Activity and their
competence:

Director/camerawork – Thea de Chavez

Who & how many are at
risk from this Activity?

HAZARDS & CONTROLS:
How co
are you going to prevent this from ha

Filming on stairs and park

Activity Description:

Sign-off status

Cast and Crew – 4/5

Hazards
How could someone become hurt or made ill

Control meas
How are you going to prevent this from happening?

They could trip or fall down the stairs

Frequently check their steps and that the tripod isn’t in t

They could fall off the swing in the park or any park activities

Make sure that they are safe by telling them to be appro
case they cannot control it

Risk Level*: After your controls have been applied what is your assessment of the risk level of this
activity?

Add additional activities as required – by copying this section and pasting below

[* mandatory fields]

Low
Netherhall risk-assessment-form

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Netherhall risk-assessment-form

  • 1. Risk Assessment Form – Part A Reference: Sign-off status None required Blank Template [planning/approved etc] Assessment summary details Assessment title * (Simple name for reference purposes) Division:* If I were a boy music video Department:* Production Series/ Prod/Unit: Responsible Manager: Programme/Area: Thea de Chavez 11 Hamden Way Address/Tel: Media Contact office: Address/Tel: CB23 3UG Netherhall School and Sixthform Centre Queen Ediths Way CB1 8NN 01223242931 Date assessment created 21/10/2013 Assessment Outline (Summary of what is proposed) The filming of a music video, to check that the location is safe to use Confidential risk assessment? NO Assessment start date 28/10/13 Country location England Hostile / travel advisory? Location details 1 Collingwood Drive Longstanton Cambridge NB: If the country location selected is ‘Hostile’ you are required to: complete the BBC Overseas High Risk Assessment Form Crew / team (Roles, responsibilities, competencies) Review / End date 01/11/13 N/A Thea de Chavez – Camerawork and Director Attachments (Detail supporting documents) Assessor(s) * Thea de Chavez (Person drafting risk assessment) Authoriser(s) * (Person responsible for sign-off) Distribution (Who gets a copy of the assessment) Assessor safety competence Date signed-off * Mr Sheppard Production Crew Data Protection Act: Personal information collected for the purposes of risk assessment will be used to identify those at risk, and those involved in controlling risk, from this or similar activities and to fulfil the BBC's obligations under Health and Safety policy and legislation. It will be retained for up to 6 years after the expiry of the activity. It may be shared with other organisations, including our agents and contractors, with whom the risk or the control of risk is shared. Activity and Hazard Summary [This is a summary of the activities listed in part B of the risk assessment.] Activity Who Exposed Hazards{hazard titles Filming on stair, park Cast and Crew Possibility of tripping and falling [* mandatory fields] Activity Risk Rating LOW
  • 2. Risk Assessment Form – Part A Blank Template Comments log Who by Date / time received Comments Assessor response Date/ time responded Risk Assessment Form – Part B Reference: [enter reference number]] 6 ACTIVITIES: What are you doing, where, for how long and who will be involved? Complete the fields in the form below). Activity Title:* Filming on stairs – someone might trip/fall Park – They could hurt themselves List those managing this Activity and their competence: Director/camerawork – Thea de Chavez Who & how many are at risk from this Activity? HAZARDS & CONTROLS: How co are you going to prevent this from ha Filming on stairs and park Activity Description: Sign-off status Cast and Crew – 4/5 Hazards How could someone become hurt or made ill Control meas How are you going to prevent this from happening? They could trip or fall down the stairs Frequently check their steps and that the tripod isn’t in t They could fall off the swing in the park or any park activities Make sure that they are safe by telling them to be appro case they cannot control it Risk Level*: After your controls have been applied what is your assessment of the risk level of this activity? Add additional activities as required – by copying this section and pasting below [* mandatory fields] Low