UHV Risk Assessment Guidelines
Compliance Subject: Briefly describe the compliance activity being assessed
Responsible Department: The Department responsible for this compliance activity.
Title of Responsible Supervisor:
Responsible Office Within Department: Specific Office responsible for compliance.
Prepared by: The name of the person who prepared this assessment.
Assessment Date: The date this assessment was completed.
Check one: If this is the first formal assessment of this compliance activity, check New Assessment. If making changes to an existing
assessment, check Updated Assessment.
List the compliance activity first, then show the specific law, regulation, policy (or policies) or other legal basis that make this a required
Risk of Non-Compliance
In this column describe the most likely possible consequence(s) of non-compliance. Be as specific as possible: e.g. fine (how much),
reprimand, loss of funding, loss of accreditation, negative publicity, audits, employee injury, litigation, etc.
H-High Impact (If the risk happens, we will probably not achieve our objective or to do so will require major damage control.)
M-Medium Impact (If the risk happens, we will have to do extra work or we will be inefficient, but we can still achieve our objective.)
L-Low Impact (If the risk happens, we will be aware of it but will have little or no effect upon operations or achieving the objective.)
Probability of Occurrence
H-High Probability (It will happen often)
M-Medium probability (It is likely to happen but not often)
L-Low Probability (It is unlikely to happen at all)
Operating Controls - The controls that must be properly and consistently applied to manage the risk to an acceptable level.
Monitoring and Oversight Controls
Monitoring Controls - Generally those procedures performed by the supervisor to determine that the required operating controls are being
Oversight Controls - Generally those procedures used by middle or upper management to ensure that monitoring controls have been
applied as designed, i.e. including reviews of status reports, exception reports, etc.
Evidence or Other Written Documentation of Compliance
(1) What documents or other proof is created that can be shown to an auditor or other reviewer that will verify that the required operating
controls were completed?
(2) What documentation can be produced to show that the supervisor has indeed monitored for compliance?.. i.e. supervisor initials and
dates on some document or report; notations or supervisor's initials on a reconciliation, exception reports, written memo or other
documentation initiated by the supervisor.
Rank After Controls
High -Generally risk that, if it occurs, can have an institutional wide impact and major damage control will be required.
Med - Generally, a risk that, if should happen, it will have isolated or area only impact but we can still achieve our goal or objective.
Low - Generally, a risk that, if it happens will be low level in its impact with little or no effect upon operations.
Manage - Generally, the highest risks that need to be constantly managed to insure that the appropriate controls are being applied.
Monitor - Generally, medium level risks that still may require considerable risk management and monitoring.
Accept - Generally, lower level risks that are accepted, requiring little management and/or monitoring.
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Risk Assessment Form
Compliance Subject: Elevator Evacuation Procedures This Form Prepared by: Gregory Fanelli
Responsible Department: Safety and Risk Management Assessment Date: 6/20/07 Check one:
Responsible Office within Department: NA New Assessment: xxxx
Title of Responsible Supervisor: Safety and Risk Manager Updated Assessment:
Rank After Mitigation
Prob. of Occurrence
Risk of Non-Compliance
Compliance Activity (I.e. fine, reprimand, loss of
funding, loss of accreditation, High Manage
(including statutory laws, regulations, Med Monitor
unfavorable publicity, audits,
policy(s) or other legal basis for investigations, employee injury, Low Accept
compliance) litigation or other negative Monitoring and/or Oversight Evidence or Other Written
consequences. Controls Documentation of Compliance
1 Elevator Operation and Evacuation -Passenger injury due M L 1. Formalized written Elevator Evacuation 1. Annual review of elevator M Manage 1. Written Elevator Evacuation Procedure
Procedure to comply with to improper or unsafe Procedure posted to Campus Safety procedures by Safety and Risk readily accessible and available for
-ASME A17.1 Safety Code for extraction. Manual and placed in elevator Manager prior to refresher audit/review.
Elevators and Escalators, -Litigation and mechanical room of each facility having training. 2. Certificates of Compliance are posted in
-ASME A17.1, Rule 211.3, possible significant elevators. 2. Weekly inspection of elevators each elevator.
Firefighters Service Operation, liability if serious injury 2. Annual refresher training of select by duty Security Officer to verify 3. Security Officer inspection logs available
-ASME A17.3 Safety Code for to passenger occurs. employees at each campus in proper emergency elevator phone is to document monthly inspections. Work
Existing Elevators. -Fines imposed by elevator evacuation procedures. operating properly. orders generated by Security Officers to
-ASME A17.4 Guide for Emergency Texas Department of 3. Easily accessible, written, laminated 3. Monthly inspection to verify Facility Services available for inspection.
Evacuation of Passengers from Licensing and quick reference instruction sheet completion of Monthly Fire 4. Monthly Fire Fighters Service Test Log
Elevators. Regulation if each including emergency contact information Fighters Service Test Log by kept in elevator mechanical rooms of each
-Texas Health and Safety Code, elevator is not in each elevator mechanical room. factory elevator service facility and available for audit/review.
Section 754.016 inspected annually in 4. Annual required inspections by TDLR technician. If inspection 5. Weekly emergency elevator phone
accordance with coordinated by Facilities Services incomplete or not performed, operation verifications can be seen in
Texas Dept of Maintenance Coordinator to receive new Security Officer notifies Facilities Security Officer Shift report.
Licensing and elevator Certificate of Compliance. Services by online work order.
Regulation rules. 5. Monthly inspection of each elevator 4. Annual application and
performed under contract/po with factory inspection of each elevator by
authorized service provider. State Licensed Inspector.
C:\Docstoc\Working\pdf\2beb6c53-6fa7-4b7c-b55f-412375c985b9.xls Elevator Operation-Evacuation