ACTIVITY HAZARDRISKH/M/L PRECAUTIONS
IN PLACE
REVIEW DATE REVIEWER
Dancing
Holding mugShaking rattle
Posing with the wedges
Moving map around
Banging head on fence.
Tripping. Hot drink – Hot mug.Hitting their self on the head.
Falling
Paper cut
L
MHM
H
H
Keeping my distance while dancing.Only head dance.Let the drink cool.Make sure the rattle keeps a distance.Make sure she keeps balance and the floor it flat and safe.Use a laminated map.
Yes
YesYesYes
Yes
Yes
Please leave this section blank:Risk Assessment checked by: Name ………………………………………………….. Signed …………………………………………………. Date ……………………
KEY: Activity : Describe the component part of your pursuit.Hazard : List the things you anticipate might cause harm or the things associated with your activity that have the potential to cause harm. Consider the likely
harm.Risk: Assess the risk as either H (High), M (Medium) or L (Low). When concluding your assessment consider all of the circumstances.Precautions: Consider what you could do to minimise / negate the risk.In Place: Will the precautionary measures be in place at the time of the activity?Review Date: When would it be reasonable to review your assessment? Remember it might be whilst you are undertaking the activity.Reviewer: Name of the person responsible for completing the risk assessment.
A copy of this form should be taken on the activity or visit by the Reviewer.V9/PALL/sspi/reviewedOct2010
V 9 RISK ASSESSMENT