1. Risk Assessment Form – Part A
Blank Template
Reference: [enter reference number]] Sign-off status [planning/approved etc]
Assessment summary details
Assessment title *
(Simple name for reference
purposes)
On the Film Set
Division:* Cheadle College Department:* Creative Media
Series/ Prod/Unit: Unit 4,5,62 Programme/Area: Computer Rooms
Responsible
Manager:
Jamie Ingham Contact office: Cheadle College
Address/Tel: Cheadle Rd Cheadle,
Stockport, Cheshire SK8
5HA
0161 486 4600
Address/Tel: Cheadle Rd Cheadle, Stockport,
Cheshire SK8 5HA
0161 486 4600
Date assessment created 09/06/2013 Confidential risk
assessment?
YES/NO (delete as applicable)
Assessment Outline
(Summary of what is
proposed)
To detail some of the dangers when working on our set when creating the
advertisement.
Assessment start
date
09/06/2013 Review / End date
/10/06/2013
Country location England Hostile / travel
advisory?
Location details On site of a college. 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)
Lewis Gray(Lighting), Jade Kinder(interviewer), Connor Murray(Assistant Camera Man) and Chris
Mcklosky(Camera Man)
Attachments
(Detail supporting
documents)
None
Assessor(s) *
(Person drafting risk
assessment)
Lewis Gray
Assessor safety
competence
Authoriser(s) *
(Person responsible for
sign-off)
Jamie Ingham Date signed-off * 09/06/2013
Distribution
(Who gets a copy of the
assessment)
Every Crew Member and Client
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 Activity Risk Rating
Filming Interviewee Tripping on lines. 3
Comments log
Who by Date / time
received
Comments Assessor response Date/ time
responded
Lewis Gray 09/06/2013 Very Dangerous None 09/06/2013
[* mandatory fields]

2. [* mandatory fields]

3. Risk Assessment Form – Part B
Blank Template
6Reference: [enter reference number]] Sign-off status [planning/approved etc]
ACTIVITIES: What are you doing, where, for how long and who will be
involved? Complete the fields in the form below).
HAZARDS & CONTROLS: How could someone become hurt or made ill and
how are you going to prevent this from happening?
Activity Title:* Tripping On Camera equipment like cables and tripods.
Activity Description: When working on the set there are going to be a number of cables lying around on the floor it is very important that we make
sure that nobody trips up on them as this could cause serious injury.
List those managing
this Activity and their
competence:
Lewis Gray. Extremely Competent.
Who & how many are
at risk from this
Activity?
Everyone who is going to be on the set on the day that we are shooting the video.
Hazards
How could someone become hurt or made ill
Control measures
How are you going to prevent this from happening?
Breaking a leg or they could hit there head of an object and
cause brain injury or even a fracture.
Celotape all the wires to the ground to make it a smooth and safe working environment.
Someone could get serious back ache by spending to long at a
computer when editing all the footage together and writing up
reports for the project.
Make sure that everyone takes a 5 minute break every hour, this can be done by simply walking around
the classroom in a circle.
Risk Level*: After your controls have been applied what is your assessment of the risk level of
this activity?
High/Medium/Low (delete as applicable)
Add additional activities as required – by copying this section and pasting below
[* mandatory fields]

4. Risk Assessment Form – Part B
Blank Template
6Reference: [enter reference number]] Sign-off status [planning/approved etc]
ACTIVITIES: What are you doing, where, for how long and who will be
involved? Complete the fields in the form below).
HAZARDS & CONTROLS: How could someone become hurt or made ill and
how are you going to prevent this from happening?
Activity Title:* [activity 2 title]
Activity Description:
List those managing
this Activity and their
competence:
Who & how many are
at risk from this
Activity?
Hazards
How could someone become hurt or made ill
Control measures
How are you going to prevent this from happening?
[Hazard 1 title and description] [Details of control measures]
[Hazard 2 title and description]
[add additional rows as required]
[Details of control measures]
Risk Level*: After your controls have been applied what is your assessment of the risk level of
this activity?
High/Medium/Low (delete as applicable)
Add additional activities as required – by copying this section and pasting below
[* mandatory fields]