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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)


     Division:*                                                                         Department:*

     Series/ Prod/Unit:
                                                                                 Programme/Area:


   Responsible                                                                          Contact office:
Manager:

Address/Tel:                                                                     Address/Tel:




Date assessment created                                                          Confidential risk                      YES/NO (delete as applicable)
                                                                                 assessment?


    Assessment Outline
(Summary of what is
proposed)

     Assessment start                                                                   Review / End
date                                                                             date


     Country location                                                                Hostile / travel
                                                                                 advisory?

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


     Crew / team
(Roles, responsibilities,
competencies)


    Attachments
(Detail supporting
documents)


     Assessor(s)    *                                                               Assessor safety
(Person drafting risk                                                            competence
assessment)


     Authoriser(s) *                                                             Date signed-off *
(Person responsible for
sign-off)


    Distribution
(Who gets a copy of the          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
assessment)                      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



Comments log
Who by             Date / time        Comments                                            Assessor response                                  Date/ time
                   received                                                                                                                  responded



 [* mandatory fields]
Risk Assessment Form – Part B                                                               Blank Template



Reference:
6                          [enter reference number]]                           Sign-off status          [planning/approved etc]

    ACTIVITIES:    What are you doing, where, for how long and who will be           HAZARDS & CONTROLS:           How could someone become hurt or made ill and
involved? Complete the fields in the form below).                                 how are you going to prevent this from happening?

      Activity Title:*         [activity 1 title]

      Activity Description:



    List those managing
this Activity and their
competence:

   Who & how many
are at risk from this
Activity?

                          Hazards                                                                         Control measures
How could someone become hurt or made ill                      How are you going to prevent this from happening?
[Hazard 1 title and description]                               [Details of control measures]




[Hazard 2 title and description]                               [Details of control measures]

[add additional rows as required]




    Risk Level*: After your controls have been applied what is your assessment of the risk level of         High/Medium/Low             (delete as applicable)
this activity?

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




    [* mandatory fields]
Risk Assessment Form – Part B                                                               Blank Template



Reference:
6                          [enter reference number]]                           Sign-off status          [planning/approved etc]

    ACTIVITIES:    What are you doing, where, for how long and who will be           HAZARDS & CONTROLS:           How could someone become hurt or made ill and
involved? Complete the fields in the form below).                                 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                                                                         Control measures
How could someone become hurt or made ill                      How are you going to prevent this from happening?
[Hazard 1 title and description]                               [Details of control measures]




[Hazard 2 title and description]                               [Details of control measures]

[add additional rows as required]




    Risk Level*: After your controls have been applied what is your assessment of the risk level of         High/Medium/Low             (delete as applicable)
this activity?

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




    [* mandatory fields]

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Safety risk assessment-form_dec09

  • 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) Division:* Department:* Series/ Prod/Unit: Programme/Area: Responsible Contact office: Manager: Address/Tel: Address/Tel: Date assessment created Confidential risk YES/NO (delete as applicable) assessment? Assessment Outline (Summary of what is proposed) Assessment start Review / End date date Country location Hostile / travel advisory? NB: If the country location selected is ‘Hostile’ you are Location details required to: complete the BBC Overseas High Risk Assessment Form Crew / team (Roles, responsibilities, competencies) Attachments (Detail supporting documents) Assessor(s) * Assessor safety (Person drafting risk competence assessment) Authoriser(s) * Date signed-off * (Person responsible for sign-off) Distribution (Who gets a copy of the 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 assessment) 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 Comments log Who by Date / time Comments Assessor response Date/ time received responded [* mandatory fields]
  • 2. Risk Assessment Form – Part B Blank Template Reference: 6 [enter reference number]] Sign-off status [planning/approved etc] ACTIVITIES: What are you doing, where, for how long and who will be HAZARDS & CONTROLS: How could someone become hurt or made ill and involved? Complete the fields in the form below). how are you going to prevent this from happening? Activity Title:* [activity 1 title] Activity Description: List those managing this Activity and their competence: Who & how many are at risk from this Activity? Hazards Control measures How could someone become hurt or made ill How are you going to prevent this from happening? [Hazard 1 title and description] [Details of control measures] [Hazard 2 title and description] [Details of control measures] [add additional rows as required] Risk Level*: After your controls have been applied what is your assessment of the risk level of High/Medium/Low (delete as applicable) this activity? Add additional activities as required – by copying this section and pasting below [* mandatory fields]
  • 3. Risk Assessment Form – Part B Blank Template Reference: 6 [enter reference number]] Sign-off status [planning/approved etc] ACTIVITIES: What are you doing, where, for how long and who will be HAZARDS & CONTROLS: How could someone become hurt or made ill and involved? Complete the fields in the form below). 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 Control measures How could someone become hurt or made ill How are you going to prevent this from happening? [Hazard 1 title and description] [Details of control measures] [Hazard 2 title and description] [Details of control measures] [add additional rows as required] Risk Level*: After your controls have been applied what is your assessment of the risk level of High/Medium/Low (delete as applicable) this activity? Add additional activities as required – by copying this section and pasting below [* mandatory fields]