Instructions for using the Risk Assessment form

Column 1b Describe the work activity to be carried out. Not

not fill in names of machines/equipment to be used. Therefore, a compute
activity, but working on a computer is

Column 1c Identify hazard(s) and its risks associated with the activity to be carried out.
Examples of hazards include chemical, biological, electrical, mechanical, physical, ergonomics, psychosocial, sl
Identify possible accidents/ill health associated with each identified hazard. Ex
possible accidents/ill health include fires, explosions, cuts, burns, frost bites, fractures etc.

Column 1d Group exposed

List who might be harmed such as patients, staff, visitors.
Note: Vulnerable such as pregnant lady, disabled, children etc.to be considered.

Column 1e Risk Area:

Hospital Premises ( both interior and exterior) where the risk is present.

Column 2b Inherent risk

L=Likelihood of occurrence of an accident, incident or ill health is defined as the probability that the s
incident or ill health will happen. Choose the likelihood from a value between 1 and 5. Consider the re
such events happening in the past when deciding on the likelihood. Refer to the Ri
tab for the likelihood table.

Column 2c S=Severity is the degree or extent of injury or harm caused by the hazards, or as a result of an acciden
the most likely severity from a value between 1 and 5, rather than the most extreme. Refer t
Matrix tab for the severity table

Column 2d Risk Rating

Risk Rating = Combination of Likelihood X Severity.

Column 3a Existing control measures

Indicate risk control measures that are already in place to eliminate or minimize risks.
Elimination of the hazard should take first priority while PPE should be the last line of defense.
- Elimination
- Substitution

-Engineering Controls
- Administrati

Protective Equipment
Column 3b Residual Risk Rating
The residual risk is the amount of risk or danger associated with an action or event remaining after inherent ri
reduced by risk controls
L=Likelihood
L may reduce upon introduction of existing control measures

Column 3c S=Severity Sm
upon introduction of existing control measures

Column 3d Risk Rating =Severity X Likelihood

Will reduce upon introduction of existing control measures

Column 3e Additional risk control measures are required when the Risk Rating indicated in column 2d exceeds 6.
6 or less, enter "NA" in the column

Column 3f Enter the name of the person appointed to oversee the implementation of the control measures.
Enter the frequency of implementation.
 Note: Please do
Therefore, a computer is not an

al, ergonomics, psychosocial, slip & fall etc.

Examples of
actures etc.

d.

d as the probability that the said accident,

ween 1 and 5. Consider the records of
Refer to the Risk Matrix

s, or as a result of an accident. Choose

ost extreme. Refer to the Risk

e risks.
line of defense.

- Substitution

- Administrative Controls
- Personal
ent remaining after inherent risks have been

S may reduce

ated in column 2d exceeds 6. If the RPN is

control measures.
 Risk Assessment Matrix
Overall Risk = Likelihood x Severity

Likelihood Table Severity Table

Score 5 4 3 2 1 Score 5 4 3 2 1
Severity level Frequent Moderate Occasional Remote Unlikely Likelihood level Critical Very Serious Serious Marginal Negligible
Multiple Fatalities Single Fatality Serious injuries Injuries Minor injuries,
requiring off-site requiring on-site which may
treatment by treatment by require self-
medical or medical administered
immediate practitioner. first aid. Injured
evacuation to Personnel personnel can
hospital. Potential unable to continue to
Occurs several times a Has occurred in Never occurred in long term or continue to perform normal
Occurs several times a Has occurred at
year in healthcare Healthcare facility healthcare facility permanently perform duties. duties
year in India least once in India
facilities in India (Worldwide) (Worldwide) disabling effects.

Risk level Determination - 5 x 5 Matrix Risk Category and Action

SEVERITY Colour code Score Risk catogory Action

Critical Very Serious Serious Marginal Negligible Operation not Permissible

(5) (4) (3) (2) (1) 15 - 25 Extreme Stop operation & review controls.

25 20 15 5 High priority remedial action

Frequent 10 Proceed with extreme caution. Implement
(5) Operation not Operation not Operation not
High priority
Review at 8 - 14 High additional controls immediately. Emergency control
permissible permissible permissible appropriate time measures shall be in place.

20 16 4
Moderate 12 8 Take remedial action at appropriate time
(4) Operation not Operation not
High priority High priority
Review at 4 -6 Medium Proceed with care. Additional control is advised.
permissible permissible appropriate time
LIKELIHOOD

6
15
Occasional 12 9 Review at 3
Operation not
(3) High priority High priority appropriate Risk acceptable Risk acceptable: Residual risk
permissible If possible, risk reduction should be further
time
considered, particularly severity.
1-3 Low Risk There are no imminent dangers. Frequent review
4 shall be in place especially changes in procedures,
6
Remote 10 8 Review at 2 materials or environment.
Review at
(2) High priority High priority appropriate Risk acceptable
appropriate time
time

4
5
Unlikely Review at 3 2 1
Review at
(1) appropriate Risk acceptable Risk acceptable Risk acceptable
appropriate time
time
 FMS RISK ASSESSMENT- UTILITY SYSTEMS

RISK SCORE RISK CATEGORY ACTION Risk Assessment Reference No:

1-3 Low There are no imminent dangers. Frequent review shall be in place especially changes in procedures, materials or environment. Facility Name: Yashoda Hospitals, Hitec City
Take remedial action at appropriate time
4-6 Medium Proceed with care. Additional control is advised. Review at appropriate time. FMS Program: Utility Systems

8-12 High High priority remedial action Proceed with extreme caution. Implement additional controls immediately. Emergency control measures shall be in place. Date of Assessment: 06/03/2024

15-25 Extreme Operation not Permissible. Stop operation & review controls. Next Review Date:

HAZARD IDENTIFICATION RISK EVALUATION RISK CONTROL

Inherent risk Rating Residual

Risk Rating
Sl No. Process / Activity Hazard and its risk Groups Exposed Risk Area Existing Control Measures Additional Control measures Responsible person (Action/Monitored
by)
L S RR L S RR

(HVAC,Fire Fighting,Plumbing sytesm & Gasplant )

Need lights permanently and

Terrace all water tanks need to
1 Terrace water Taking tourch light to check tank level in nigts and at a time 2 has to cover entire tank area AGM /Senior Manager/
be locked and lights required at Someone may fall on tanks Plumbing team 3 4 3 2
tanks plumbers will go for checking also will keep locking for Shift Engineer
top of tank areas
tanks
Temporary UPS lights are arrranged in some area AGM /Senior Manager /
2 If power failures it will effect to HVAC plant operartor and Need lights permanently and
Terrace area need UPS lighting Terrace area 3 4 3 2 Deputy Manager / Shift
employee all employees has to cover entire area
Engineer

Need mono rail system for

If Primary pump failure for particular AGM /Senior Manager /
3 Water Cooled chiller primary entire chiller plant area for
chiller it has a time taking process to Entire Hospital Terrace 3 4 Backup Chiller will be switched on and run the plant 3 2 Deputy Manager / Shift
pumps removing or fixing of heavy
remove pump engineer
motors can easily do it.

Need mono rail system for

If condesor pump failure for particular AGM /Senior Manager /
4 Water Cooled chiller condensor entire chiller plant area for
chiller it has a time taking process to Entire Hospital Terrace 3 4 Backup Chiller will be switched on and run the plant 3 2 Deputy Manager / Shift
pumps removing or fixing of heavy
remove pump engineer
motors can easily do it.

If Aircooled chiller primary pump Need to install Back up AGM /Senior Manager /
5 Aircooled chiller Primary pump failures don’t have a back up pump to Entire Hospital Terrace 3 4 Backup Chiller will be switched on and run the plant 3 2 pump parrallel to Existing Deputy Manager / Shift
run it pump. engineer

There is no proper path way go to

Need an Iron Structure AGM /Senior Manager /
Cooling tower area pathway coolingtower area which they are going Employees who are Proper PPE wearing and they are walking slowly on top of pipe
6 Terrace 4 4 3 2 which need a clear path way Deputy Manager / Shift
required to check cooling tower employees working in chiller plant and collect data.
direct to Cooling tower. engineer
walking top of 300 dia pipe

PPE usingh while taking chemicals.

Cooling tower chemicals are stored in Store Room need Permanent
Cooling tower chemical store AGM /Senior Manager /
Store room need an exhaust facility and Employees who are Exhaust system, Eye wash
7 room need ventilation and 15Th floor 3 4 3 2 Deputy Manager / Shift
eyewash facility.Also monitoring working in chiller plant Station and Smoke
smoke detector engineer
purpose need an Smoke detector. deterctor.

Need to keep permmanent

The door handle lock is not working AGM /Senior Manager /
Chiller Panels door handles are Employees who are best quality handle to
8 properly and some are damaged and it Terrace 3 4 We have managed to keep an Block to stop the door to come out 3 2 Deputy Manager / Shift
broken working in chiller plant operate which can withstand
is in door open position. engineer
it more frequently use it.

9 Toilet Exhaust Fans failures
Exhaust fan is getting failure for dust Need to buy alternate AGM /Senior Manager /
We are doing PPM for exhaust fans and have a back up for Each
and direction of rain water flow motor is All Toilet areas All areas 3 3 3 2 Exhaust fan which can repair Deputy Manager / Shift
model of Exhaust fans
getting damaged easily engineer

Need to maintain AGM /Senior Manager /

If any one of the failures it effects entire We are doing PPM for AHU /CSU/ TFA/FCU and have a back up
10 AHU /CSU/ TFA/FCU At particular Area All areas 3 3 3 2 motors,Belts and required Deputy Manager / Shift
area of AC for motors
spare parts engineer

11
 FMS RISK ASSESSMENT- UTILITY SYSTEMS

RISK SCORE RISK CATEGORY ACTION Risk Assessment Reference No:

1-3 Low There are no imminent dangers. Frequent review shall be in place especially changes in procedures, materials or environment. Facility Name: Yashoda Hospitals, Hitec City
Take remedial action at appropriate time
4-6 Medium Proceed with care. Additional control is advised. Review at appropriate time. FMS Program: Utility Systems

8-12 High High priority remedial action Proceed with extreme caution. Implement additional controls immediately. Emergency control measures shall be in place. Date of Assessment: 06/03/2024

15-25 Extreme Operation not Permissible. Stop operation & review controls. Next Review Date:

HAZARD IDENTIFICATION RISK EVALUATION RISK CONTROL

Inherent risk Rating Residual

Risk Rating
Sl No. Process / Activity Hazard and its risk Groups Exposed Risk Area Existing Control Measures Additional Control measures Responsible person (Action/Monitored
by)
L S RR L S RR

12
 FMS RISK ASSESSMENT- UTILITY SYSTEMS

RISK SCORE RISK CATEGORY ACTION Risk Assessment Reference No:

1-3 Low There are no imminent dangers. Frequent review shall be in place especially changes in procedures, materials or environment. Facility Name: Yashoda Hospitals, Hitec City
Take remedial action at appropriate time
4-6 Medium Proceed with care. Additional control is advised. Review at appropriate time. FMS Program: Utility Systems

8-12 High High priority remedial action Proceed with extreme caution. Implement additional controls immediately. Emergency control measures shall be in place. Date of Assessment: 06/03/2024

15-25 Extreme Operation not Permissible. Stop operation & review controls. Next Review Date:

HAZARD IDENTIFICATION RISK EVALUATION RISK CONTROL

Inherent risk Rating Residual

Risk Rating
Sl No. Process / Activity Hazard and its risk Groups Exposed Risk Area Existing Control Measures Additional Control measures Responsible person (Action/Monitored
by)
L S RR L S RR
 FMS RISK ASSESSMENT- UTILITY SYSTEMS

RISK SCORE RISK CATEGORY ACTION Risk Assessment Reference No:

1-3 Low There are no imminent dangers. Frequent review shall be in place especially changes in procedures, materials or environment. Facility Name: Yashoda Hospitals, Hitec City
Take remedial action at appropriate time
4-6 Medium Proceed with care. Additional control is advised. Review at appropriate time. FMS Program: Utility Systems

8-12 High High priority remedial action Proceed with extreme caution. Implement additional controls immediately. Emergency control measures shall be in place. Date of Assessment: 06/03/2024

15-25 Extreme Operation not Permissible. Stop operation & review controls. Next Review Date:

HAZARD IDENTIFICATION RISK EVALUATION RISK CONTROL

Inherent risk Rating Residual

Risk Rating
Sl No. Process / Activity Hazard and its risk Groups Exposed Risk Area Existing Control Measures Additional Control measures Responsible person (Action/Monitored
by)
L S RR L S RR

26

27
 FMS RISK ASSESSMENT- UTILITY SYSTEMS

RISK SCORE RISK CATEGORY ACTION Risk Assessment Reference No:

1-3 Low There are no imminent dangers. Frequent review shall be in place especially changes in procedures, materials or environment. Facility Name: Yashoda Hospitals, Hitec City
Take remedial action at appropriate time
4-6 Medium Proceed with care. Additional control is advised. Review at appropriate time. FMS Program: Utility Systems

8-12 High High priority remedial action Proceed with extreme caution. Implement additional controls immediately. Emergency control measures shall be in place. Date of Assessment: 06/03/2024

15-25 Extreme Operation not Permissible. Stop operation & review controls. Next Review Date:

HAZARD IDENTIFICATION RISK EVALUATION RISK CONTROL

Inherent risk Rating Residual

Risk Rating
Sl No. Process / Activity Hazard and its risk Groups Exposed Risk Area Existing Control Measures Additional Control measures Responsible person (Action/Monitored
by)
L S RR L S RR

28

29

30

Prepared by: CH.DURGAPRASAD Signature: Date:

Reviewed by : Signature: Date:

Approved by: Signature: Date: