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Risk Matrix Template 20
Risk Matrix Template 20
Description of
activity and/or Selection, setup and use of a MEWP for a task
location.
Signed: Signed:
Date: Date:
Other risk
assessments which
Risk Assessment for specific task being carried out on a mobile elevated work platform
might also be
required:
Risk Assessment and Fall from Heights due to MEWP User Potentially eliminating the
Possible
selection of MEWP for wrong selection Working at heights so no (2)
Major (3) High (6)
job MEWP is required.
Malfunction of MEWP Visitors/Public in vicinity Type of Work to be carried
out evaluated with selection
Emergency Plan
Hiring the MEWP and Malfunction of MEWP due MEWP User Give Specific instructions to
Receiving from to damage Hire Company Where to meet
company you so that you can show
Unlikely Moderate
them where to leave MEWP. (1)
Major (3)
(3)
Keys to be handed to person
hiring MEWP personally
Setting up the Task for Fall from Heights MEWP User Pre Start completed by
using MEWP operator and Spotter on Possible Severe
High (8)
MEWP and all defects are (2) (4)
noted.
Malfunction of MEWP Visitors/Public in vicinity Brief the Work Group on Type
of Work to be carried out
Collision with other MEWP Other trades Work Group should know the
or Structure Safe Working Load of MEWP
Commencing the Fall from Heights MEWP User Pre Start briefing Completed
Working at Height Task and MEWP been operated as
Possible Severe
per the Manufacturers (2) (4)
High (8)
requirements
Finish Task and clean Fall from Heights MEWP User Clean up Work area removing Unlikely
Major (3)
Moderate
up. Pickup of MEWP all Trip Hazards (1) (3)
circumstances
People Affected None or few (e.g. 0 to 2) Small numbers (e.g. 3 to 10) Moderate numbers (e.g. 10 to 50) Wide scale (e.g. more than 50)
Extent of people potentially affected
Reputation and Legal None or issue raised by staff or students Internal scrutiny to prevent escalation and Medium-term stakeholder concern, Persistent stakeholder concerns,
Potential for publicity with a negative and resolved promptly by management. short-term stakeholder concern national media scrutiny and ‘brand’ international media scrutiny and long term
impact on reputation / potential for legal None or legal dispute – found not guilty – Minor non-compliance, limited notification impact. ‘brand’ impact.
prosecution fines up to $3 million (Body Corporate), to regulators / affected stakeholders Medium non-compliance, moderate Significant non-compliance, extensive
$600,000 (Officer) notification to regulators / affected notification to regulators / affected
stakeholder, potential for legal stakeholders, potential for legal
proceedings / fines proceedings / imprisonment / fines
Operations None or business interruption < 4 hours. Business interruption between 4 hours to Business interruption > 5 days. Business interruption of many weeks.
Extent of ability to maintain core business None or effectiveness and efficiency of a 5 days. Medium operational impact resulting in Breakdown of key activities and significant
service, programme or project impacted in Operational disruption manageable by delay of key deliverables. long-term impact.
the short term. workarounds. Major damage to property or equipment Massive damage to property or equipment
None or slight damage to property or Moderate damage to property or
equipment equipment
The final score for each risk is calculated by multiplying the likelihood and consequences response scores. This will give a risk score of between 1 and 16.
All risks rates as “High” or “Extreme” require detailed analysis of mitigating practices / controls to determine the residual risk rating. Action must be taken.
“Low” and “Moderate” risks may be excluded from further analysis (other than when the consequence may be severe). However the rationale for excluding these risks should be
documented to demonstrate the completeness of analysis undertaken. Some action may be required.
Other than in the most unlikely circumstance, risks that can cause major or severe harm to people have been determined as “high” or “extreme”.
Management review is considered appropriate for risks of these nature due to the potential magnitude of the impact, even though the likelihood may be assessed as relatively low.
Intolerable risk.
Extreme
(12-16)
Immediate action(s) is to be taken by Faculty/Service HSW risk owners - including DVCs, Deans of Faculties, Directors of Services, Academic Heads/PIs, Services
Managers. Work should not be started or continued until the risk has been reduced to as low as reasonably practicable using the hierarchy of risk controls. The
Associate Director Health, Safety and Wellbeing, and Manager Risk and Performance must be advised of the risk for their review. The risk should be included in
the UoA wide risk register.
(6-9)
Urgent action is to be taken by the immediate manager. Work should not be started or continued until the risk has been reduced to as low as reasonably
practicable using the hierarchy of risk controls. The HSW Manager working with the Faculty/Service, and Manager Risk and Performance must be advised of the
risk for their review. To be included in the UoA wide risk register.
(3-4)
Management to monitor risks in case changing circumstances increase the level of risk. Some action may be required, e.g. improving controls.
(1-2)
Requires no further attention above routine practices and procedures, apart from monitoring.
Note: This Health and Safety Risk Assessment Matrix aligns with WorkSafe NZ guidance, UoA Resilience Management Plan, UoA Risk Determination Matrix, UoA TVRA and UoA Incident Levels
Description of
activity and/or Selection, setup and use of a MEWP for a task
location.
Faculty/ Service
Document No: 0 0
Division:
Description of
activity and/or Selection, setup and use of a MEWP for a task
location.
Faculty/ Service
Document No: 0 0
Division:
Description of
activity and/or Selection, setup and use of a MEWP for a task
location.
Faculty/ Service
Document No: 0 0
Division:
Description of
activity and/or Selection, setup and use of a MEWP for a task
location.
Faculty/ Service
Document No: 0 0
Division:
Copy of risk
assessment issued
Controls covered in
procedure & Issued
Reference of formal
communication to staff
Staff handbook issued
to staff
Other
Induction
Toolbox Talk/Standup
Additional Methods of
Team Meeting
Communication
Email circulation
Description of
activity and/or Selection, setup and use of a MEWP for a task
location.
Other
Notes:
Use the "Assessment Tab" to complete the Risk Assessment. Use A list of tasks then risks for
1 Assessment Tab
each task for more complex activities.
Use drop down selections for likelihood and consequence and the risk vales will be automatically
2 Dropdowns for Risk Calc
be calculated.
Risk calculations can be completed just per each section OR per individual line by line risk if
3 Line by Line, or in Sectio
needed
4 Add Lines/Sections Just copy and paste to add as many lines as necessary for more lines of hazards/risk
The HIGHEST risk value from the list of all selected risk will be automatically calculated and
5 Highest Risk Level
shown at the top of the page
If desired, use the Actions, Controls and Review tab to note how controls will be implement and
6 Actions Tab
to track actions
7 Print Layout Pages in the default version are laid out for easy printing on A4, Landscape
Do not delete the notes tab as the values for calculations are below (if in doubt or if there are
8 Notes Tab
errors, retrieve the original template)
Changes
3.1 Minor Fix calcs, some layout changes (fonts) and put header rows at top of pages