Generic OHS Risk Assessment Control Form

Note: There are some checklists available for the identification of hazards associated with specific tasks such as Manual Handling,
Forklift Safety, Overseas Travel – refer to OHS Web site http://www.swinburne.edu.au/corporate/hr/ohs/

CLUB Risk Assessment completed by

Location/Venue Club committee position

Date

Describe the Activity & location

Step 1 Identify
How will the controls be
the activity
Current Residual implemented?
risk Step 5 What further risk
Complex or lengthy Step 2 What are Step 3 Who might
Step 4 What are you rating action is necessary? rating
activities should be the hazards? be harmed and Action by Due Date When
broken down into already doing? Apply the Hierarchy of Controls Refer last Completed
stages / alternately
how? Refer last
page page
aspects of the Refer last page
(optional) (required)
activity may be
listed

Risk Assessment Template Sept 2010 1

Step 1 Identify
How will the controls be
the activity
Current Residual implemented?
risk Step 5 What further risk
Complex or lengthy Step 2 What are Step 3 Who might
Step 4 What are you rating action is necessary? rating
activities should be the hazards? be harmed and Action by Due Date When
broken down into already doing? Apply the Hierarchy of Controls Refer last Completed
stages / alternately
how? Refer last
page page
aspects of the Refer last page
(optional) (required)
activity may be
listed
Step 1 Identify
How will the controls be
the activity
Current Residual implemented?
risk Step 5 What further risk
Complex or lengthy Step 2 What are Step 3 Who might
Step 4 What are you rating action is necessary? rating
activities should be the hazards? be harmed and Action by Due Date When
broken down into already doing? Apply the Hierarchy of Controls Refer last Completed
stages / alternately
how? Refer last
page page
aspects of the Refer last page
(optional) (required)
activity may be
listed
 HIERARCHY OF CONTROLS
RISK ASSESSMENT RATING – Use this table to determine a risk rating Start at the top and work down
1) What is the worst possible CONSEQUENCE of this hazard? Most
2) What is the LIKELIHOOD of this occurring?
Elimination
Effective Eg. Discontinue use of product, equipment, cease work process

RISK LIKELIHOOD
RATING Substitution
Almost Eg. Replace with a similar item that does the same job but with a
Rare Unlikely
Possible Likely Certain lower hazard level
The event will The event is
The event The event is The event is
CONSEQUENCE only occur in not likely to
may occur likely to occur almost certain
exceptional occur in a
circumstances year
within a year within a year to occur within Isolation
a year Eg. Put a barrier between the person and the hazard
Catastrophic
(Accidental death / Significant Significant
High Risk High Risk High Risk
serious injury) Risk Risk Engineering controls
Major Moderate Eg. Change the process, equipment or tools so the risk is reduced
Significant
(Serious injury) Low Risk Risk High Risk High Risk
Risk
Moderate Moderate
(Lost time due to Low Risk Low Risk
Significant
High Risk Administration controls
Risk Risk
workplace injury) Eg. Guidelines, procedures, rosters, training etc to minimise the
Minor risk
(Minor workplace Moderate Significant
Low Risk Low Risk Low Risk
injury – no lost time) Risk Risk
Minimal Personal protective equipment
Moderate Least
(No injury) Low Risk Low Risk Low Risk Low Risk Eg. Equipment worn to provide a temporary barrier
Risk Effective

Documentation and approval

Name Signature
Please print Date / /

Contact No.

Verified by club Signature

committee member #2
Date / /