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FORM 14.1 RISK IDENTIFICATION AND ASSESSMENT TEMPLATE Site: Assessment completed by: Date:

Area Assessed

Describe the specific location of the hazard

What are the Hazards?

Existing Controls What actions are required?

Enter further actions required to remove/manage the risk refer to table 2 below for priority requirements

Risk Rating Refer to table 1

below

Action Owner: ………………………Due date: / /




-






Area Assessed Describe the specific location of the hazard

What are the Hazards?

Existing Controls What actions are required?

Enter further actions required to remove/manage the risk refer to table 2 below for priority requirements

Risk Rating Refer to table 1

below











Table 1 – Risk Assessment Matrix

How likely is it to be that bad? ++

Very likely. Could happen at any

time

+ Likely.

Could happen sometime

- Unlikely.

Could happen but rarely

- - Very unlikely.

Could happen but probably never will

How

sev

ere

coul

d th

e ou

tcom

e be

? DEATH Death, permanently disability or ill health 1 1 2 3

!!! Long term illness or serious injury 1 2 3 4

!! Medical attention & days off work 2 3 4 5

! First aid needed 3 4 5 6

Table 2 – Severity Rating by WHS, Environment and Quality Standards and Associated Action Priority WHS Environmental Quality RISK ACTION PRIORITY

CO

NSE

QU

ENC

E Kill or cause permanent disability or ill health

Critical environmental issue or pollution potential that could threaten the survival of the organization

Critical quality issue. Could threaten the survival of the organisation

1-2 Immediate action required to reduce the risk

!!! Cause long term illness or permanent injury

Long term pollution or significant cost to organisation

Recall or significant cost to organisation 3-4 Action in a timely manner,

WMS to be completed

!! Cause someone to need medical attention and be off work for several days

Transient pollution requiring clean up or cost to organisation

Customer complaint involving non conforming product 5-6 Schedule action to review

and reduce the risk

! Cause someone to need first aid Minor pollution No clean up required Minor non conformance detected

before it reaches the customer ALL RISKS MUST BE ELIMINATED

WHERE POSSIBLE





Signoff of Risk Assessment and Actions Completed by: .…………………………………..… Signature: ...………..............………….... Date: …………… Agreed by Manager: ………………………..…….. Signature: ...….......……………...…....... Date: …………… Comments: * NOTE – this form is to be used to identify risks and provide a preliminary assessment. The Company SEQ System form 19.1 (Corrective Action Report) must be completed for all medium to high risks which are not able to be mitigated immediately.





PROCESS TO BE CARRIED OUT The process of risk ranking any hazard above should be carried out in the following manner: • Ensure that the consultative group has sufficient expertise

and information regarding the hazard. • Identify a realistic scenario and assess the probable severity

or other impact. Table 1 • Assess in consultation with other employees the probability

of the chosen severity occurring. • From Matrix 1 read off the number at the meeting point of

the column & row selected. • The risk rating priority is the Word shown against the number

in Table 1.

This risk ranking will be used to determine the priority given to reducing the hazard and the type of controls applied. Finally we need to decide on the controls or safeguards that we need to apply to the risk. Sometimes this is obvious and sometimes the control is defined in legislation but in other cases we need to apply controls on the basis of the control hierarchy and work our way down until we come across a viable control.





HIERARCHY OF CONTROLS In NSW the legislation requires us to apply the controls in the following hierarchy

• Elimination • Substitution • Mitigation • Isolation • Work organisations • Personal Protective Equipment (PPE)

To simplify this list we normally use the following criteria: Elimination/substitution This relates to removing the risk either by completely eliminating it or substituting another process that reduces the risk. Engineering solution This means that we apply a physical barrier or other engineering solution to the risk. The reliability of this solution is generally good but the cost is sometimes high. Administrative controls These include training, PPE supervision etc. Whilst they are attractive in terms of cost and are often quick to apply the reliability of these controls is generally poor as they rely upon people to ‘do the right thing’. Hazard prompt sheet (over page) The following guidewords are developed to prompt the identification of hazards, and are to be used as guidance only. By no means should this list be considered a definitive and complete set of potential hazards. These should be used in combination with descriptors (prefixes) such as ‘exposure to, loss of control, loss of protection, failure/malfunction/breakdown, etc.’









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14.1 Risk Identification and Assessment TEMPLATEhumanelement.biz/SEQ System/4. Forms and Work Method Statements... · FORM 14.1 RISK IDENTIFICATION AND ASSESSMENT ... reducing the