Activity

Risk Assessment Form Part A

Division / StudioDepartment / Series

Business Unit / ProductionAddressProducer / Editor

Tel:

Mobile:Roxanne Meats07799

Start date07.02.2015End date07.02.2015

Distribution

Who gets a copy of the assessmentRoxanne Meats and Sophie Marriott

Outline of risk assessment

Summary of what is proposedTo keep safe on shoot at the PQA Tonbridge Wells

Team members / experts / contractors / contributors etc.

List those involved Roxanne Meats and Sophie Marriott

Locations

Outline locations involved indicate any which are hostile environmentsTonbridge Wells PQA

Assessor Name

SignatureRoxanne Meats Date completed05.02.2015

Authoriser Name

(if not Assessor)SignatureDate authorised

Hazard list select your hazards from the list below and use these to complete Part B

Situational hazardsTickPhysical / chemical hazardsTickHealth hazardsTick

Assault by personxContact with cold liquid / vapourDisease causative agent

Attack by animalContact with cold surfaceInfection

Breathing compressed gasContact with hot liquid / vapourAllergic reaction

Cold environmentContact with hot surfaceLack of food / water

Crush by loadElectric shockLack of oxygen

DrowningExplosive blastPhysical fatigue

Entanglement in moving machineryExplosive release of stored pressureRepetitive action

High atmospheric pressureFireStatic body posture

Hot environmentHazardous substanceStress / anxietyx

Manual handlingIonizing radiationVenom poisoning

Object falling, moving or flyingxLaser light

Obstruction / exposed featureLightning strikeEnvironmental hazards

Sharp object / materialNoiseLitter

Shot by firearmNon-ionizing radiationNuisance noise / vibration

Slippery surfaceStroboscopic lightPhysical damage

Trap in moving machineryVibrationWaste substance released into air

Trip hazardxWaste substance released into soil / water

Vehicle impact / collisionManagerial / organisational hazards

Falls from heightManagement factors (lack of communication, co-operation, co-ordination and competence)

Risk matrix use this to determine risk for each hazard i.e. how bad and how likelyLikelihood of Harm

Severity of HarmRemote

e.g. 1 in 3 chance

Negligible e.g. small bruiseTrivialTrivialTrivialLowLow

Slight e.g. small cut, deep bruiseTrivialTrivialLowLowMedium

Moderate e.g. deep cut, torn muscleTrivialLowMediumMediumHigh

Severe e.g. fracture, loss of consciousnessLowMediumHighHighExtremely high

Very Severe e.g. death, permanent disabilityLowMediumHighExtremely highExtremely high

Risk Assessment Form Part B

Activity1 Each individual activity you are proposing:Filming in school environment Location where this activity will take place:Tonbridge Wells Dates / times:07.02.15, 10-14

Hazards2List what could cause harm from this activity

e.g. falls from height, trip hazard, fire, etc.Who exposed

List who might be harmed from this activity

e.g. staff, contractors, contributors, public, etc.Risk3For each hazard, decide level of risk as if you were to do the activity without your controlsControl measures

For each hazard, list the measures you will be taking to minimise the risk identified

e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective equipment, provision of first aid, etc.Risk3For each hazard, decide level of risk once all your controls are in place

Assault by personStaffLowMake sure each staff member helps each other when around people not involved in the production.Trivial

Object FallingStaffLowBe careful of surroundings Trivial

Trip Hazard

Staff LowMake sure all staff are briefed on where the cables are.Trivial

Stress

StaffLowWhile dealing with children make sure a teacher is always around to assistTrivial

Continue on separate sheet if necessary

1 complete separate table for each activity 2 - from hazard list in Part A 3 - from risk matrix in Part A