OHS017

Risk assessment completed by:

OHS Risk Assessment and Staff/student number:
Control Form

Faculty/Division: School/Unit:

Document number Initial Issue date Current version Current Version Next review date
Issue date

For additional information refer to the OHS Risk Assessment and Control Procedure, the OHS Risk Rating Procedure and the Hierarchy of Risk Controls.

Risk Assessment title:

Step 1: Identify the activity

Describe the activity:

Describe the location:

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Risk Assessment and Control Form Date Effective: 01/01/2007
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Step 2: Identify who may be at risk by the
activity
A number of people may be at risk from any activity. This may affect the risk controls needed. These people may include fellow workers, visitors, contractors and the public. The
location of the activity may affect the number of people at risk.

Steps 3 to 7: Identify the hazards, risks, and rate the

risks

1. An activity may be divided into tasks. For each task identify the hazards and associated risks.
2. List existing risk controls and determine a risk rating using the UNSW Risk Rating Procedure.
3. Additional risk controls may be required to achieve an acceptable level of risk. Re-rate the risk if additional risk controls used.

Risk rating with Additional risk controls Risk Rating with

existing controls * required additional controls *
Hazards Associated risks
Tasks Existing risk controls (Step 5) (Step 6) (Step 7)
(Step 3) (Step 4)
C L R (Apply the hierarchy C L R
of risk controls)

* C = consequence L = likelihood R = risk rating from the UNSW Risk Rating Procedure

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Risk Assessment and Control Form Date Effective: 01/01/2007
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Step 8 Documentation and supervisor
approval
Completed by: (name) (signature) Authorised by: (name) (signature) Date:

Step 9: Implement the additional risk

controls identified
Indicate briefly what additional risk controls from Step 6 above were implemented, when and by whom.

Risk control: Date: Implemented by:

Risk control: Date: Implemented by:

Risk control: Date: Implemented by:

Risk control: Date: Implemented by:

Risk control: Date: Implemented by:

Step 10: Monitor and review the risk

controls
It is important to monitor risk controls and review risk assessments regularly. Review is required when there is a change in the process, relevant legal changes, and where a
cause for concern has arisen. Reviews could be scheduled on an annual basis. If the risk assessment has substantially changed a new risk assessment is warranted.
Review date: Reviewed by: Authorised by:

Review date: Reviewed by: Authorised by:

Review date: Reviewed by: Authorised by:

Review date: Reviewed by: Authorised by:

Review date: Reviewed by: Authorised by:

Documentation
It is a requirement that legal and advisory documentation that supports this risk assessment be listed. Such documentation includes Acts, Regulations, Australian Standards and
Codes of Practice, where applicable.

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Risk Assessment and Control Form Date Effective: 01/01/2007
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For details on how to use this table see: OHS328 Risk Rating Procedure

CONSEQUENCES

Level Descriptor Examples

1 Insignificant Injuries not requiring first aid
2 Minor First aid required
3 Moderate Medical treatment required
4 Major Hospital admission required
5 Severe Death or permanent disability to one or more
persons

LIKELIHOOD

Level Descriptor Examples

A Almost certain Is expected to occur in most circumstances
B Likely Will probably occur in most circumstances
C Possible Could occur at some time
D Unlikely Not likely to occur in normal circumstances
E Rare May occur only in exceptional circumstances

RISK RATING MATRIX

Consequences
Likelihood
Insignificant Minor Moderate Major Severe
1 2 3 4 5
Almost certain
A
Medium High High Very high Very high
Likely
B
Medium Medium High High Very high
Possible
C
Low Medium High High Very high
Unlikely
D
Low Low Medium Medium High
Rare
E
Low Low Medium Medium Medium

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Risk Assessment and Control Form Date Effective: 01/01/2007
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