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Risk Assessment
Who am I?
Name and Surname
Name and Surname
1
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What am I doing?
Brief Description of the Task
Brief Description of the Task
1
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Risk Assessment
Question
Answer
Question
Answer
1
Who is working with me?
2
Who is my supervisor?
3
Who is my department head?
4
Who is my safety representative?
5
Who told me to do this work?
6
Who is supervising me doing this work?
7
When was I trained for this task?
8
When last did I read the formal risk assessment for this task?
9
When was I observed doing this task safely?
10
What is the instruction (name and number) for this task?
11
What safety precautions must I take?
12
When was the machine last maintained?
13
What safeties are on the machine?
14
What safeties are not on the machine?
15
Is the machine safe to work on or with?
16
What document (name and number) describes the material I am handling?
17
Is the material safe to handle as per the instructions?
18
What can touch me?
19
What can I touch?
20
What can fall on me?
21
What can I fall into?
22
What can I be caught in, between or on?
23
What can hit me?
24
What can I do, that could injure me?
25
What else can go wrong?
26
What will I do to prevent bad things from happening?
27
What PPE am I wearing?
28
Do I feel safe to continue working?
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