RISK ASSESSMENT RECORDING FORM

Location or
Address: PA.20
Activity or
Situation
(1)

Hazard

Having a drink next to a computer

and spilling it.

Date Assessment
Undertaken: 25th January
Review
Date: 29th January

Assessment undertaken
By: 28th January
Signature

Risk

(2) Who might be harmed and how?

(3) What controls exist to reduce

Risk

(4) What action can be taken

15

The person using the computer

could be harmed by being
electrocuted.

No drinks near the computers.

No drinks out atoll in the

classroom.

Anyone in the room could be

harmed by this as anyone could try
to walk somewhere and trip over a
chair.

Minimal movement around the

room.

Stay seated unless teacher gives

permission.

Tripping over tables and chairs.

3

To further reduce risk?

Tripping over bags on the floor.

Anyone in the room could be

harmed by tripping over a bag.

Minimal movement around the

room.

Bags under tables at all times.

Over hanging cables.

Anyone in the room could be

harmed.

Cable ties should be used on all

computers.

Everyone tidies their computer.

(1)

Hazard

Risk

(2) Who might be harmed and how?

(3) What controls exist to reduce

Risk

(4)What action can be taken

To further reduce risk?

RISK RATING
a SEVERITY

b LIKELIHOOD

c FINAL SCORE RATING: what needs to be done

Dying or being permanently disabled

Will almost certainly happen

Serious injury/long term illness

Highly likely to happen

Temporary disability/3 days off sick

Not so likely

Will need medical attention

Even less likely

Minor injury eg. Bruise, graze

Unlikely to happen at all

16-25 Stop! Do not start activity again until risk is

controlled
10-15 High risk level, High priority. Take action
straight away to control the risk
6-9
Medium risk level. Tighten up controls and
make a plan to do something about risk
3-5
Fairly low risk level. Low priority but keep
possible action in mind
1-2
Low or trivial risk. No further action
required.

SO: a x b = c
Action Required

Responsible Person

Date for Completion