Risk Assessment Form.

RISK ASSESSMENT FORM

Production Name & Number         -

Shoot Dates                                -

Production Manager                     -

Producer                                    -

Guidance:

1.     Assess whether a hazard will be present, write YES or NO.  Then for each hazard that you have said YES to do the following:

2.     Rate each risk on a Severity scale from Negligable (N), Low risk (L), Moderate risk (M), Severe (S), Very severe (V)

3.     Rate each risks Likelihood on scale from Very unlikely (VU), Unlikely (U), Possible (P), Likely (L), Very likely (VL)

4.     Determine the Risk Factor from the table overleaf.

P = Present      /           S = Severity     /           L = Likelihood  /           R = Risk Factor

	Hazard	P	S	L	R
1	Alcohol/drugs	NO
2	Animals/insects	YES	N	VU	1
3	Audiences	NO
4	Camera cable/grip equipment	NO
5	Confined spaces	NO
6	Derelict buildings/dangerous structures	NO
7	Electricity/gas (other than normal supplies)	NO
8	Fatigue/long hours	NO
9	Fire/flammable materials	YES	N	VU	2
10	Hazardous substances	NO
11	Heat/Cold/extreme weather	YES	L	P	2
12	Laser/strobe effects	NO
13	Machinery/industrial/ crane/hoist	NO
14	Materials - glass, non-fire retardant set materials	NO
15	Night operation	NO
16	Noise – high sound levels	YES	N	U	1
17	Non standard manual handling	NO
18	Public/crowds	YES	L	VL	3
19	Radiation	NO
20	Scaffold/Rostra	NO
21	Smoking on set	NO
22	Special effects/explosives	NO
23	Special needs (elderly, disabled, inexperienced)	YES	L	P	2
24	Specialised rescue/first aid	NO
25	Stunts, dangerous activities	NO
26	Tall scenery/suspended ceilings	YES	N	VU	1
27	Vehicles/speed	YES	M	P	3
28	Water/proximity to water	NO
29	Weapons	NO
30	Working at heights	NO
31	Working overseas	NO
32	Other risks	NO

5. Calculate the Risk Factor:

	Very Unlikely	Unlikely	Possible	Likely	Very Likely
Very severe	3	4	4	5	5
Severe	2	3	3	3	5
Moderate	2	2	3	3	3
Low Risk	1	2	2	3	3
Negligible	1	1	2	2	3

6. Decide the action to take:

5	Very severe	Take immediate action
4	Severe	High priority
3	Moderate Risk	Programme for action
2	Low Risk	Action may be required
1	Negligible	Probably acceptable

7. Then list each risk identified

Hazard Number:	11.
Description of Hazard:	Possible bad weather, often cold and could be raining.
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )	Cast and crew.
Action to take:	If cold weather, wear warm clothes – or take frequent breaks indoors in the warmth. If raining, wear waterproof clothes, and shelter indoors for heavy rainfall.
Person/company responsible for action	Nicola Sinclair.
Hazard Number:	18.
Description of Hazard:	Very busy environment due to college students/train station. Passerbys could injure themselves on equipment.
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )	Public.
Action to take:	Could possibly get some crew members to work as runners, and stop people from having accidents with the equipment or actors. Could even place barriers to stop people from getting near the actors/equipment.
Person/company responsible for action	Nicola Sinclair.
Hazard Number:	23.
Description	Occasionally disabled people pass through the college plaza, and could potentially have an accident with equipment/cast.
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )	Public.
Action to take:	Once again, runners could stop people from getting too near the equipment and the cast, or barriers could be set up to prevent accidents.
Person/company responsible for action	Nicola Sinclair.
Hazard Number:	27.
Description	There is a small road next to the set, although not busy.
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )	Cast and crew.
Action to take:	Avoid filming near/in the roads, and take care whilst crossing or being beside them.
Person/company responsible for action	Nicola Sinclair.

To be completed at agreed later date -
Exposed person(s) informed?	Y	Agreed action taken?	Y	Risk removed?	Y

Completed by: Nicola Sinclair.                                               Position: Director.

Signature: Nicola Sinclair.                                          Date: 03/10/2013.