Risk Assessment Form Part A
Scene(s) –
Production Title: Access Advert Organisation Access
Production Address: St James Buildings, 79 Producer(s) Thomas Houston
Oxford St, Manchester Tel:
M1 6FQ Email:
Start date 12/12/17 End date
Distribution Jonna Rogers, Amy Cooke, Keerthi Swertha, Lucas Sancho
Who gets a copy of the
assessment
Outline of risk assessment
Summary of what is proposed
in terms of sequences and set
ups
On site cast/crew 5
Locations Studio
Hostile environments marked
with *
Hazard list – Select your hazards from the list below to inform Part B.
Situational hazards Tick Physical/chemical hazards Tick Health hazards Tick
Assault by person Contact with cold liquid/vapour Disease causative agent
Attack by animal Contact with cold surface Infection
Breathing compressed gas Contact with hot liquid/vapour Allergic reaction
Cold environment Contact with hot surface Lack of food/water x
Crush by load Electric shock Lack of oxygen
Drowning Explosive blast Physical fatigue x
Entanglement in moving x Explosive release of stored pressure Repetitive action
machinery
High atmospheric pressure Fire Static body posture
Hot environment Hazardous substance Stress/anxiety
Manual handling x Ionizing radiation Venom poisoning
Object falling, moving or x Laser light
flying
Obstruction/exposed Lightning strike Environmental hazards
feature
Sharp object/material Noise Litter
x
Shot by firearm Non-ionizing radiation Nuisance noise/vibration
Slippery surface Stroboscopic light Physical damage
Trap in moving machinery x Vibration Waste substance released into air
Trip hazard x Waste substance released into
soil/water
Vehicle impact/collision Managerial/organisational hazards
Falls from height Management factors (lack of communication, x
co-operation, co-ordination and competence)
Risk matrix
Risk Assessment Form Part B
– use this to determine
risk for each hazard i.e. ‘how bad and
Likelihood of Harm = Slight Remote (>1 in 1,000 chance)
Scene(s) –
how likely’
Severity of Harm Remote Very unlikely Unlikely Possible Likely
>1 in 1000 chance >1 in 200 chance >1 in 50 chance >1 in 10 chance >1 in 3 chance
Negligible e.g. small bruise Trivial Trivial Trivial Low Low
Slight e.g. small cuts, deep bruise Trivial Trivial Low Low Medium
Moderate e.g. deep cuts, torn muscle Trivial Low Medium Medium High
Severe e.g. fracture, loss of Low Medium High High Extremely
consciousness high
Very Severe e.g. death, permanent Low Medium High Extremely Extremely
disability high high
Hazards Who is Risk Control measures Risk
List what could cause exposed For each hazard, For each hazard, list the measurements you will be For each
harm from this activity decide the level of taking to minimise the risk identified hazard, decide
List who might be
e.g. falls from height, risk before control e.g. appointing competent persons, training received, the level of risk
harmed from this
trip hazard, fire etc. measures are in planning and rehearsals, use of protective equipment, once all
activity
place provisions of first aid etc. controls are in
e.g. crew, cast place
etc.
trip over equipment cast, crew low Make everyone aware that heavy Trivial
equipment is being used. Keep equipment
supervised at all times. clear the space so
people can easily move around the
equipment.