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					                                           UHV Risk Assessment Guidelines
                                                                  (Revised 6/07)
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.
                                                               Compliance Activity
List the compliance activity first, then show the specific law, regulation, policy (or policies) or other legal basis that make this a required
compliance activity.
                                                             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.
                                                                Potential Impact
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

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.
                                                             Mitigation Strategies

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.

        C:\Docstoc\Working\pdf\2beb6c53-6fa7-4b7c-b55f-412375c985b9.xls Guidelines 11/20/2011                                        1 of 2
                  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
                                                                                                                                                                                                                            Controls     Strategy

                                                                                                 Potential Impact
                                                                                                 (Before Controls)

                                                                                                                       (Before Controls)
                                                                Risk of Non-Compliance
    Item Number

                            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
                                                                                                                                                     Operating Controls
                                                                        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

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