Risk Assessment Checklist: Insert Company Logo Here
Risk Assessment Checklist: Insert Company Logo Here
Risk Assessment Checklist: Insert Company Logo Here
Here
PREPARATION:
Before undertaking a risk assessment:
Select personnel to be a part of the risk assessment team and a leader of the team should be appointed.
The leader of the team should be a competent person (have the skills, knowledge and experience) to undertake the risk management process and have a good understanding of the work processes to be
assessed.
All persons involved in the risk assessment should have an understanding of the work processes to be assessed.
The team should consist of management / supervision, a health and safety representative (where elected) and a worker directly related to the work.
The risk assessment team should consult with the worker(s) who undertake the work, or who will be directly affected by the work.
The leader of the risk assessment team should:
Consult with those involved and agree on a date and time to undertake the risk assessment.
Ensure the team has the appropriate resources available for the assessment, i.e. note pads, pens, tape measure, level and noise meter (where necessary).
Ensure the plant or chemical substances associated with the work processes are available during the risk assessment.
Have copies of plant and equipment operating manuals, operating procedures and maintenance manuals, along with any safety data sheets (SDS) for substances to be used or produced during the work
processes.
The risk assessment team should:
Review the pre purchase risk assessment for any new plant or hazardous chemicals (where completed) to identify any pre-existing hazards that will need to be assessed.
Review the risk assessment checklist to ensure they fully understand how it is to be used.
Risk assessment the work process under normal operating conditions (or simulate where not practical).
Is the risk assessment due to new or proposed changes to plant and equipment, a work process, hazardous chemicals or the environment? YES NO
If Yes, please tick the corresponding box: Plant and Equipment? Work Process? Hazardous Chemicals? Environment?
If No is the risk assessment required due to a hazard that has not been previously risk assessed? (Please tick) YES NO
If Yes, was the hazard identified as a result of Hazard Report? (Please tick) YES NO
If No, was the hazard identified as a result of Incident Report? (Please tick) YES NO
If none of the above describe the reasons for the risk assessment
review e.g. safety management system / document review
Title:
Location of Activities:
Worker(s)
Personnel Exposed:
Consulted:
Date
Additional Comments:
Conducted:
A Almost certain The event is expected to occur Recurring event during the lifetime of a project/operation e.g. More than once per month
B Likely The event will probably occur Event that may occur frequently during the lifetime of a project/operation e.g. At least once per year
C Possible The event should occur Event that may occur during the lifetime of a project/operation e.g. Once in 3 years
D Unlikely The event could occur Event that is unlikely to occur during the lifetime of a project/operation e.g. Once in 10 years
The event may occur only in exceptional
E Rare Event that is very unlikely to occur during the lifetime of a project/operation e.g. Once in 15 years
circumstances
Work Health and Safety Resource Manual – October 2017 ISBN 978-1-925361-14-8 Page 4 of 17
Risk Assessment Checklist
Revised
Risk Record controls or actions to eliminate or minimise
Is there a possibility of injury or damage due to: Y N Record how and when injury or damage could occur Risk
Level the risk of injury or damage
Level
WORKING CONDITIONS – summarise: (isolated or remote), start and finish times, number of days per week, hours per day, overtime requirements
Note! The following section is from the Code of Practice for Hazardous Manual Tasks - Refer to the Code for guidance on control measures
Definitions: Repetitive means: the movement or force is performed more than twice a minute, Sustained means: the posture or force is held for more than 30 seconds at a time
Step 1: Does the task involve repetitive or sustained movements, postures or forces? If you tick yes then the task is a risk and must be controlled
forward
Bending more than 20 degrees
sideways
twisting
forward
twisting
Lifting or lowering
Step 2: Does the task in step 1 involve long duration? If you tick yes then the task is a risk and must be controlled
Step 3: Does the task involve high or sudden force? If you tick yes then the task is a risk and must be controlled
Kicking or jumping
Step 4: Is there hand, arm or whole body vibration? If you answer yes in step 4, then the task requires further investigation
PLANT - MAJOR – Summarise fixed / mobile plant or equipment: crushing plant / control room, excavator, FEL, dump truck, mobile jaw crusher, screendeck, forklift, watercart etc.
PLANT - MINOR – Summarise tools / equipment to be used: oxy welder or arc, hand operated cordless / electric or pneumatic powered tools, shovel, hammers etc.
Plant Names Plant Identification No’s.
HAZARDOUS CHEMICALS – Summarise chemicals: liquids, powders, aerosols, pellets, cleaners, solvents, glues, paints, sealers, oils, fuels and poisons
Note: for any asbestos related work, refer to the Code of Practice - How to Manage and Control Asbestos in the Workplace.
List any hazardous chemicals the worker may use or handle:
(obtained from Safety Data Sheet or label on container, drum or packaging)
Are there up to date Safety Data Sheets
Yes No
available for each chemical?
Are the chemical(s): If no document Safety Data Sheets required and obtain from supplier / manufacturer
Skin or Digestive Irritant? Toxic or Poisonous? Corrosive / Caustic? Classified as Dangerous Goods?
Eye or Respiratory Irritant Flammable or Combustible? Classified as Hazardous Substance? Reactive or Explosive?
This section is for assessing risks associated with tasks involving the use of hazardous chemicals, a separate pre-purchase risk assessment will be required for all hazardous chemicals brought to site.
OTHER PERSONS – Summarise: work that may place the health and safety of a third party at risk of injury or damage (other than an worker)
Action Plan
Action No Action required Responsibility Completion Date Review Date
10
11
12
13
14
15
16
17
18
19
Risk Assessment Checklist
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40