Risk Assessment Example Form
Risk Assessment Checklist
Risk Assessment Completed by: Date:
Description Who might be Existing Control Measures A. B. Risk Rating Comments/Actions
Likely Likely (A) x (B)
and location of harmed severity of Occurrence
Hazard injury (1 to 3)
(1 to 3)
Slip, trips and falls Staff and visitors working Reasonable housekeeping 2 2 4 Ensure that all trailing cables are
at and attending the standards maintained managed by if possible re-
event Stairs well lit and handrails provided routing or digging in. If trailing
Repairs and maintenance carried out wires can not be avoided they
when necessary must be covering and/or
Entrance well lit highlighting.
Score 3 2 1
Column A: Severity of Injury: Major Injury or death Injury requiring medical treatment Minor or no injury
Column B: Likely Occurrence: Regular exposure of several Occasional exposure of few Exposure to hazard very rare.
employees to hazard. employees.