Insert Company Logo Risk Assessment Checklist

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).

CONDUCTING THE RISK ASSESSMENT:

The risk assessment team, in consultation with the worker(s) who undertake the work, or who will be directly affected by the work, should conduct the risk assessment in the following manner:
 The risk assessment team leader to complete the details on the second page of the risk assessment checklist.
 The team should assess each key step of the work process including the preparation, undertaking the work and the cleanup processes etc.
 Complete each part of the risk assessment checklist by answering the questions in each category of the checklist in the following manner:
1. Identify any Hazard and tick YES where there is a possibility of injury or damage or NO where there is not;
2. Where YES has been ticked, describe the Hazard (how and when the injury or damage could occur);
3. Assess the risk of injury or damage from the Hazard using the risk matrix:
 Assess the likelihood of injury or damage as a result of coming into contact with the hazard and select a level indicator; and
 Assess the most likely consequences as a result of injury or damage occurring and select a level indicator.
 Follow the likelihood column across and the consequences column down on the risk matrix to the point where they both meet to obtain the risk level (rating) for each Hazard.
 Document the risk level in the risk rating column and identify and document the appropriate risk controls and actions using the hierarchy of control for each hazard identified.
 Reassess the risk level after risk controls and actions have been implemented.

COMPLETING ACTION PLAN

The team in consultation with relevant workgroup should:
 Record each risk control and action in the corrective action plan located at the end of the document.
 Assign time frame / date for completion, person(s) responsible for corrective action completion, and review with regular meetings for close out of outstanding actions.
 Verification of the completed actions needs to be completed by management and documented.

MONITORING AND REVIEWING RISK CONTROLS

The risk assessment team in consultation with relevant workgroup:
 Should monitor and review each risk control and action to ensure controls are effective and no other hazards have been created and introduced into the work.
Work Health and Safety Resource Manual – October 2017 ISBN 978-1-925361-14-8 Page 1 of 17
 Risk Assessment Checklist

REASONS FOR RISK ASSESSMENT

Company:       Site Location      

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?

Describe the change:      

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

Additional Details or Comments:

     

Work Health and Safety Resource Manual Page 2 of 17

 Risk Assessment Checklist
RISK ASSESSMENT - DESCRIPTION Risk Assessment Completed By

Description of Activities:       Name:      

Title:
Location of Activities:            

Worker(s)
Personnel Exposed:            
Consulted:

Date
Additional Comments:            
Conducted:

RISK MATRIX HIERARCHY OF CONTROL

Consequences The Hierarchy of Control must be used
Likelihood when determining how risks are going to be
1 2 3 4 5
Insignificant Minor Moderate Major Catastrophic Eliminated or Minimised.
Start at No. 1 and work down the order.
A - Almost
M H E E E 1. Elimination – remove the hazard from
Certain
the workplace
2. Substitution – use a different (safer)
process, machine or chemical
3. Isolation - as much as possible, isolate
B - Likely M H H E E the hazard or hazardous work practice from
people
4. Engineering – install guards on
machines, put in barriers around hazards
C - Possible L M H H E 5. Administrative controls – use
policies, training and signs to warn workers
6. Personal protective equipment (PPE)
– use gloves, glasses, hearing protection
etc.
D - Unlikely L L M H H
Personal protective equipment is always the
last option used
in the hierarchy of control as a
E - Rare L L M H H means of protection!

Work Health and Safety Resource Manual Page 3 of 17

 Risk Assessment Checklist
Risk Matrix Legends
Rating Safety Health Environment
Single minor injury to one person. Issues of non-continuous nature with promptly reversible
1 Reversible health effects of minor concern only
First aid or no treatment required. impact or consequence (e.g. within shift). Low-level
Minor requiring minor first aid treatment.
No lost time. incident, site contained.
Issues of a non-continuous nature and minor impact and
2 Medically treated injury. Reversible injury. Reversible health effects of concern that results in
consequence. Low-level incident, site contained. Short
Moderate Does not lead to restricted duties. medical treatment but does not lead to restricted duties.
term reversible (e.g. within days).
Issues of a continuous nature - limited impact and
3 Reversible injury or moderate irreversible impairment. Severe but reversible health effects. Results in a lost
consequence Incident resulting in some site
Serious Less than 10 days lost time. time illness of less than 10 days.
contamination. Medium term recovery impact.
Compliance issue with large fine, media attention. Serious
4 Severe irreversible damage to one or more persons. Severe and irreversible health effects or disabling
harm not immediately recovered. Significant site
Major Lost Time Injury greater than 10 days. illness.
contamination or off-site impact. Long term recovery.
5 Issues of a continuous nature with major long-term impact
Fatality. Permanent disabling injuries. Life threatening or permanently disabling illness.
Catastrophic and potentially serious consequences.

Rating Descriptor Description Suggested Frequency

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

Rating Definition Level of Involvement

Cease work - No works shall be conducted until controls are

The most senior person on site (Chief Executive Officer, Managing Director, General Manager) must review and
Extreme implemented to reduce the risk level.
approve risk control measures before allowing work to recommence
Immediate formal risk assessment required.
Corrective action required.
High Normally permits required to perform work. Mine Operator and or Quarry Manager review required
Safe Work Procedure or Job Hazard Analysis is mandatory.

Corrective action required. Job Hazard Analysis or Safe Work

Moderate Supervisor / Superintendent review required
Procedure required.

Corrective action where practical.

Low Supervisor to manage by routine procedures at operational level
Take 5 risk assessment required.

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
     

Working alone / isolated or remotely from other

workers?
Note: refer to the Code of Practice - Managing the
Work Environment and Facilities.

Not being able to contact others for assistance in the

event of an emergency?

Bullying, harassment, violence or threatening

behaviour between workers?

Fatigue from working constant extended shifts

(overtime) or double shifts
Note: refer to the SafeWork Australia - Guide for
Managing the Risk of Fatigue at Work.

Fatigue from performing repetitious, monotonous work

or concentrating for extended periods of time?

Fatigue from work requiring continuous physical effort?

Being effected by dust, odours or fumes?

Poor visibility from reflective objects, bright lights, sun

glare, excessive dust or reduced lighting?

Exposure to UV radiation from the sun?

Excessive temperatures when working indoors or

outdoors? (Hot / Cold)

Working in a confined space?

Note: refer to the Code of Practice – Confined Space.

Falling from one level to another while working at

height? Note: refer to the Code of Practice - Managing
the Risks of Falls at Workplaces.

Slips, trips or falls at ground level or below?

Note: refer to the Code of Practice - Managing the
Risks of Falls at Workplaces.

Working on a fragile roof?

Perspex / fibrous cement / asbestos sheeting.
Work Health and Safety Resource Manual Page 5 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

Note: refer to the Code of Practice - Managing the

Risks of Falls at Workplaces.

Being struck by moving mobile plant or vehicles?

Note: refer to the MAQOHSC Traffic Management
Guide.

Being engulfed by a free flowing solid or liquid?

Being struck by a falling object that is being carried,

transported or lifted?

Suffocation or being crushed from falling or collapsing

materials or a structure?

Head, body or limb contact on plant or equipment due

to restricted movement in the work area?

Electrocution from contact with powerlines, electrical

cables or exposed wiring?

Being exposed to or working with asbestos related

materials during their work?
Note: refer to the Code of Practice - How to manage
Asbestos in the Workplace.

Being stung, bitten or struck by an insect or animal?

Background noise above 85db?

Note: refer to the Code of Practice - Managing Noise
and Preventing Hearing Loss at Work.

HAZARDOUS MANUAL TASKS – Summarise: tasks and associated equipment used

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

Body Part: Neck or Head

forward
Bending more than 20 degrees
sideways

Work Health and Safety Resource Manual Page 6 of 17

 Risk Assessment Checklist

twisting

Bending more than 5 degrees backward

Body Part: Back

forward

Bending more than 20 degrees sideways

twisting

Bending more than 5 degrees backward

Body Part: Arms / Hand

Working with one or both hands above shoulder height

Reaching forwards or sideways more than 30cm from

the body

Reaching behind the body

Excessive bending of the wrist

Twisting, turning grabbing, picking or wringing actions

with the fingers, hands or arms

Body Part: Legs

Squatting, kneeling, crawling, lying or jumping

Standing with most of the body’s weight on one leg

Very Fast Movements

Lifting or lowering

Carrying with one hand or one side of the body

Exerting force with one hand or one side of the body

Pushing, pulling or dragging

Very fast actions

Working with the fingers close together or wide apart

Work Health and Safety Resource Manual – October 2017 ISBN 978-1-925361-14-8 Page 7 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

Applying uneven, fast or jerky forces

Holding, supporting or restraining anything

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

More than 2 hours over a whole shift

Continually for more than 30 minutes at a time

Step 3: Does the task involve high or sudden force? If you tick yes then the task is a risk and must be controlled

Lifting, lowering or carrying heavy loads

Hitting, throwing or catching

Kicking or jumping

Applying a sudden or unexpected force including:

 Handling a live person or animal
 Applying uneven, fast or jerky forces during
lifting, carrying, pushing or pulling
 Pushing or pulling objects that are hard move or
stop e.g. a trolley
Exerting force while in a bent, twisted or awkward
posture including:
 Supporting items with hands which are above
shoulder height
 Moving items when legs are in an awkward
posture, working with fingers pinched together
or held wide apart
 Using a finger grip or pinch grip or an open
handed grip

Exerting a force with the non-preferred hand

Needing to use two hands to operate a tool designed

for one hand

The task can only be done for short periods of time

Two or more people need to be assigned to handle a

Work Health and Safety Resource Manual Page 8 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

heavy, awkward or bulky load

Workers report pain or significant discomfort during or

after the task

Stronger workers assigned to do the task

Employees say the task is physically very strenuous or

difficult to do

Workers think the task should be done by more than

one person, or seek help as it requires high force

Step 4: Is there hand, arm or whole body vibration? If you answer yes in step 4, then the task requires further investigation

Driving for long periods

Driving on rough roads

Frequent use of hand powered tools or use for long

periods

Using high grip forces or awkward postures when

using power tools

Use of machines or tools where the manufacturer’s

handbook warns of vibration

Workers being jolted or continuously shaken

Use of a vehicle or tool not suitable for the

environment or task

PLANT - MAJOR – Summarise fixed / mobile plant or equipment: crushing plant / control room, excavator, FEL, dump truck, mobile jaw crusher, screendeck, forklift, watercart etc.

Plant Name Plant Identification No.      

Model       Date of Manufacture      

Has the relevant Certificate of Compliance (CoC) been

Gas: Y N Electrical: Y N Plumbing: Y N If No? Contact licensed installer to inspect and issue
received for new installation: Tick Y or N Box
Work Health and Safety Resource Manual Page 9 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

The operator controls not located for ease of use

Note: refer to the Code of Practice - Managing the
Risks of Plant in the Workplace.

The emergency stops not located at the most likely

places for use where work is being conducted

The controls not identified and labelled correctly

The emergency stops / pull wires not clearly marked

Lanyards not installed on conveyors to AS 1755 (Use

MAQOHSC conveyor inspection checklist as a guide)

The green start buttons not shrouded or recessed?

No provisions available to lock out the plant and

dissipate stored energy

Access platforms / ladders / stairs / handrails do not

meet AS 1657 requirements?

No Residual Current Device (RCD) protection devices

installed (Fixed plant only)

No adequate provision to service / routinely grease

and oil the plant

No safe systems of work established for operating and

maintenance of the plant

Arm, hand or fingers crushed, cut or amputated by

rotating or moving parts on plant or machinery?

Hair or clothing caught by rotating moving parts of

plant or machinery?

Contact with hot or cold parts on plant or machinery?

Being burnt by (hot / cold) solid, liquid or vapour

escaping or being released from plant or machinery?

Radiation exposure from plant or machinery?

Being struck in the face / eye by ejected materials from

plant or machinery?

Work Health and Safety Resource Manual Page 10 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

Contact with exposed or damaged electrical wiring

while operating or servicing / cleaning or repairing the
plant or machinery?

Falling while working at height or from an elevated

workplace on the plant or machinery?

Mobile plant rolling over during operation?

e.g. no roll over protection (ROPS), no seat belt, etc.

Being struck by falling objects while operating mobile

plant? e.g. no cabin, falling object protection (FOPS)

Being crushed by plant or machinery during

operational or maintenance activities?

Workers untrained / not assessed for competency in

plant and machinery operation

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.      

Models       Dates of Manufacture      

Contact with compressed air?

e.g. entering the eyes, ears or under the skin

Sharp edges or objects on plant?

Contact with unguarded rotating or moving blades or

cutters?

Hands or fingers being squashed or crushed?

Being struck by material in the face or eye? e.g. slag

chippings, metal filings, swarf, dust partials, etc.
Dropping tools or equipment onto legs or feet?

Being burnt from contact with hot or cold surfaces?

Electrocution from contact with exposed or damaged

wiring of the plant?

Work Health and Safety Resource Manual Page 11 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

Radiation exposure from the plant?

e.g. arc / oxy welding
Note: refer to the Code of Practice - Welding
Processes.

Noise levels above 85db produced by the tools, plant,

equipment or materials?

Workers untrained / not assessed for competency in

the operation of plant?

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.

Incorrect labeling of chemical container?

Note: refer to the Code of Practice - Labelling of
Workplace Hazardous Chemicals.

Incorrect handling, storage or use of the chemical?

(fire or explosion)
Note: refer to MAQOHSC Hazardous Chemicals and
Dangerous Substances Management Guide

Inhaling the fumes or odour of the chemical?

Skin contact with the chemical?

Splashed in the eyes by the chemical?

Accidentally ingesting (drink or swallow) the chemical?

Note: refer to the Safety Data Sheet for information on
the chemical.

Accidentally injecting the chemical into the workers

body / under the skin?

Work Health and Safety Resource Manual Page 12 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

Any other issues related to handling, storage or use of

the chemical?
Note: refer to MAQOHSC Hazardous Chemicals and
Dangerous Substances Management Guide

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)
     

Struck by an object ejected from the plant or equipment

during operations?

Struck by a moving vehicle or mobile equipment?

Struck by a falling object that is being removed,

dismantled, erected, positioned, lifted, carried or
transported?

Property or vehicle damage from work being

undertaken

Exposure to spray drift or residue from pesticides,

herbicides, paints, adhesives, solvents, chemicals or
any materials?

Exposure to dust or fumes caused by workplace

operations?
Noise levels from work workplace operations?
Note: refer to the Code of Practice - Managing Noise
and Preventing Hearing Loss at Work.

A release of gas, power failure or disruption to

underground services

Slipping, tripping or falling from a height or at ground

level caused by work being undertaken?

Slipping, tripping or falling below ground level?

Note: refer to the Code of Practice - Excavation Work.

Work Health and Safety Resource Manual Page 13 of 17

ENVIRONMENTAL - Summarise any aspects of the work that may impact upon the environment
     

Dust escaping from the site boundaries?

Sediment escaping from the site boundaries and

polluting adjoining lands, water courses and aquifers?

Waste water leaking into the storm water drainage

system?

Polluting the land, adjoining waters or the storm water

system with fuel or chemical spillages?

Soil erosion from water movement?

A negative impact on plants and animals from use of

herbicides or pesticides

Waste material incorrectly disposed of?

Hazardous chemicals incorrectly disposed of?

 Risk Assessment Checklist

Safe Operating Procedures (SOP) relevant to risk assessment.

Safe Operating Procedure Name:

Recommendations on Methods for Ensuring Safe Work

Where a Safe Operating Procedure is developed, this Risk Assessment needs to be referenced within the document.

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