BSBWHS521

Date:

Version No:

Review Date:

Authorised by:

STEP 1 – ENTER INFORMATION ABOUT THE ACTIVITY/TASK, ITS LOCATION AND THE PEOPLE COMPLETING THE RISK ASSESSMENT

Location name:

Assessed by:

HSR/Employee representative:

Description of activity/task:

Workplace conditions (Describe layout and physical conditions – including access and egress)

List systems of work for the activity/task:

· Training

· Inspections

· SOPs

· Existing controls

· Emergency situations

Is there past experience with the activity/task that may assist in the assessment?

· Existing controls

· SOPs

· Standards

· Industry standards

· Incidents and near-hits

· Legislation and Codes

· Training

· Incident Investigation

· Guidance material

STEP 2: RISK RATING – RISK MATRIX AND DEFINITIONS

Likelihood

Consequence

Insignificant

Minor

Moderate

Major

Severe

Almost certain

Medium

High

High

Extreme

Extreme

Likely

Medium

Medium

High

Extreme

Extreme

Possible

Low

Medium

Medium

High

Extreme

Unlikely

Low

Low

Medium

High

High

Rare

Low

Low

Low

Medium

High

Likelihood

Consequence

Almost certain – will occur in most circumstances when the activity is undertaken (greater than 90% chance of occurring)

Insignificant –First aid treatment, minor injury, no time off work

Likely - will probably occur in most circumstances when the activity is undertaken (51 to 90% chance of occurring)

Minor – Single occurrence of medical treatment, minor injury, no time off work

Possible – might occur when the activity is undertaken (21 to 50% chance of occurring)

Moderate – Multiple medical treatments, non-permanent injury, less than 10 days off work

Unlikely – could happen at some time when the activity is undertaken (1 to 20% chance of occurring)

Major – Extensive injuries requiring medical treatment (e.g. surgery), serious or permanent injury/illness, greater than 10 days off work

Rare – may happen only in exceptional circumstances when the activity is undertaken (less than 1% chance of occurring)

Severe – Severe injury/illness requiring life support, actual or potential fatality, greater than 250 days off work

Risk Rating Priority for Action

Risk acceptance guide

Action

Recommended action time frame

Extreme

Not acceptable

Cease or isolate source of risk

Implement further risk controls

Monitor, review and document controls

Immediate

Up to 1 month

Ongoing

High

Generally (in most circumstances) not acceptable

Implement risk controls if reasonably practicable

Monitor, review and document controls

1 to 3 months

Ongoing

Medium

Generally (in most circumstances) acceptable

Implement risk controls if reasonably practicable

Monitor, review and document controls

3 to 6 months

Ongoing

Low

Acceptable

Monitor and review

Ongoing

STEP 3 – IDENTIFY HAZARDS AND ASSOCIATED RISK RATINGS AND CONTROLS

For each of the following prompts:

· Review the prompts/examples for each hazard that may potentially exist for the activity/task;

· Determine and record an inherent risk score by using the risk matrix;

· In the comments box, describe when and where the hazard is present;

· Specify the risk control type, for each current or proposed risk control;

· Provide a control description for each inherent or proposed risk control;

· Where proposed risk control(s) have been identified complete the Action plan

· Determine the residual risk score using the risk matrix

Hierarchy of Control (Control Type)

El – Elimination

S – Substitution

En – Engineering Is – Isolation G – Guarding

Sh – Shielding

A – Administrative T – Training In – Inspection

M – Monitoring H – Health Monitoring

P – PPE

Category – Steps in the task

Hazards

Inherent Risk Score

Control Description (Current and Proposed)

Control Type

Residual Risk Score

STEP 4 – IMPLEMENTATION AND CONSULTATION PROCESS

Determine the person responsible for reviewing and implementing the risk assessment including the identified controls. Ensure the Action plan has been completed, reviewed and signed off where proposed controls have been identified.

Obtain the authorisation of the management representative.

Ensure the HSR (if applicable) has been consulted. Ensure the employees undertaking the activity have been consulted.

Record below the names of the persons consulted.

Management representative

HSR/Employee representative

Employee(s)

Employee(s)

Employee(s)

Employee(s)

Person Responsible for implementation or escalation

Extra writing room – use this page to enter extended comments or descriptions