QUEENSLAND CORRECTIVE SERVICES
ADMINISTRATIVE FORM – SAFETY ANALYSIS WORKSHEET
Availability: Public
Implement Date: 3 December 2009
Refer procedure – Community Service Projects
Business Unit: Probation and Parole – Graffiti Removal Program
Location: ALL COMMUNITY SERVICE PROJECTS
Activity/Task: Pick up offenders at Probation and Parole location
Activity
Hazards
List the task required to perform the
activity in the sequence they are to
be carried out.
Against each task list the hazards
that could cause injury when the
task is performed.
Supervisor provided list of
offenders and location to pick up
Nil
Supervisor picks up bus and
signs offenders on
Nil
Supervisor ensures all offenders
are seated correctly
Supervisor proceeds to pick up
location two and signs on
offenders
Consequence
Date:
Permit to work required: Yes/No
Initial
risk
rating.
Controls measures
Offenders not seated correctly if
accident occurs whilst transport
this may lead to serious injury
High
General road hazards
Medium
Probability of Adverse Event or Incident during task
Residual
risk
rating
Who is responsible?
Regular checks that offenders are seated during transportation. If
offenders are not seated then the bus is to stop and offenders are
cautioned. Driving does not continue until all are seated.
Medium
Supervisor
Driver to have current drivers licence and follow road rules in line
with DOJ policy
Medium
Supervisor
List the control measures required to eliminate or minimise the risk of
injury arising from the identified hazard.
Probability
Write the name of the person responsible (
supervisor or above) to implement the
control measures identified
Consequences
Very Likely
Likely
Unlikely
Highly
unlikely
Very Likely
Good chance it will happen – has sometimes
occurred before
Life Threatening
Very serious injury or life threatening
Life
Threatening
High
High
High
Medium
Likely
Perhaps it will happen sometime – has
infrequently occurred
Serious Injury
Quite serious injury/ illness involving some
days off work
Serious Injury
High
High
Medium
Medium
Unlikely
Could happen but would be unusual – no
previous incidents recorded
Harmful
Some first aid or minor medical attention, but
no lost time
Harmful
High
Medium
Medium
Low
Highly
Unlikely
Could happen but probably never will – never
occurred before
Negligible
Some discomfort, but no medical attention
needed
Negligible
Medium
Medium
Low
Low
Administrative Form - Safety Analysis Worksheet
687317580
Version 01
Page 1 of 7
Business Unit: Probation and Parole– Graffiti Removal Program
Location: ALL COMMUNITY SERVICE PROJECTS
Activity/Task: Returning Graffiti Removal Trailer to CCS Location
Activity
Hazards
List the task required to perform the
activity in the sequence they are to be
carried out.
Against each task list the hazards that
could cause injury when the task is
performed.
Check stock against checklist
Date:
Permit to work required: Yes/No
Initial risk
rating.
Controls measures
Residual
risk rating
Who is responsible?
Lifting out 25 litre container from trailer
High
Change to 5 litre containers and secure in tubs to
prevent spillage
Low
Supervisor / Manager
Refilling water tank
Overfilling tank causing flood of trailer
Medium
Maintain constant visual on water tank level. If this
task is to difficult to complete with one person use
offender to assist. Fill tank to 450 litres and not full
capacity
Low
Supervisor
Refilling fuel tin
Over filling tin with flammable liquid
exposed
High
No smoking around the trailer or during filling the
fuel tin, clean up spills immediately and use funnel
to decant.
Medium
Supervisor
Splashing fuel in to eye
Medium
Wear goggles and gloves and use funnel
Medium
Supervisor
Over filling container with flammable
liquid exposed
High
No smoking around the trailer or during filling the
container, clean up spills immediately and use
funnel to decant.
Medium
Supervisor
Splashing fuel in to eye
High
Wear goggles and gloves and use funnel
Medium
Supervisor
Checking PPE for damage
May be residual chemicals on PPE and
damage beyond use
Low
Wear gloves and wash hands with hand wash
provided. Report damaged equipment to Manager
Low
Supervisor
Re-stocking (if required)
May be residual chemicals on PPE and
damage beyond use
Low
Wear gloves and wash hands with hand wash
provided. Report damaged equipment to Manager
Low
Supervisor
Refilling chemicals at BCC
Chemical spill
High
Wear PPE, follow local chemical spill procedures,
ensure spill kit is current and up to date and
supervision of all fill processes and training in safe
handling of chemicals.
Medium
Supervisor
Refilling chemicals
Consequence
Probability of Adverse Event or Incident during task
List the control measures required to eliminate or
minimise the risk of injury arising from the
identified hazard.
Probability
Write the name of the person responsible
(supervisor or above) to implement the control
measures identified
Consequences
Very Likely
Likely
Unlikely
Highly unlikely
Very Likely
Good chance it will happen – has sometimes occurred
before
Life Threatening
Very serious injury or life threatening
Life Threatening
High
High
High
Medium
Likely
Serious Injury
Serious Injury
High
High
Medium
Medium
Unlikely
Harmful
High
Medium
Medium
Low
Highly
Unlikely
Perhaps it will happen sometime – has infrequently
occurred
Could happen but would be unusual – no previous
incidents recorded
Could happen but probably never will – never
occurred before
Quite serious injury/ illness involving some days
off work
Some first aid or minor medical attention, but no
lost time
Some discomfort, but no medical attention needed
Negligible
Medium
Medium
Low
Low
Administrative Form - Safety Analysis Worksheet
687317580
Harmful
Negligible
Version 01
Page 2 of 7
Business Unit: Probation and Parole – Graffiti Removal Program
Location: ALL COMMUNITY SERVICE PROJECTS
Activity/Task: Graffiti Removal with High Pressure Water System
Activity
Hazards
List the task required to perform the
activity in the sequence they are to be
carried out.
Against each task list the hazards that
could cause injury when the task is
performed.
Activate tank by turning handle
Nil
Turn motor on
Date:
Permit to work required: Yes/No
Residual
risk rating
Who is responsible?
Starts at waist height, make sure there is
adequate fuel before staring and if discomfort
occurs stop process and complete incident
report
Low
Supervisor
Medium
Monitor and instruct offenders to keep a clear
and safe distance.
Medium
Supervisor
Motor catches fire through fault or
overfill
High
Follow motor operating instructions and ensure
regular maintenance occurs as per
manufactures instructions and ensure fire
extinguisher working order and is in date.
Medium
Supervisor
Unwind hose
Tripping someone with hose
Medium
Users are instructed on how to unwind the hose
and the hose use.
Low
Supervisor
Operate hose by pointing at site and
using hand trigger
Misuse of hose and pointing it at
another person or object
High
Users are instructed on how to use the hose &
trigger and users will be selected after
offenders have shown ability and responsibility
to use equipment.
Medium
Supervisor
Flying particles from cleaning surface
after spray fly into eyes
Medium
Wear goggles and gloves at all times
Low
Supervisor
Consequence
Initial risk
rating.
Controls measures
Force of pulling motor starter may
strain shoulder or back
Low
Exhaust burning on pipe or inhaling
fumes
List the control measures required to eliminate or
minimise the risk of injury arising from the
identified hazard.
Write the name of the person responsible
(supervisor or above) to implement the control
measures identified
Probability of Adverse Event or Incident during task
Probability
Very Likely
Likely
Unlikely
Highly unlikely
Very Likely
Good chance it will happen – has sometimes
occurred before
Life Threatening
Very serious injury or life threatening
Life Threatening
High
High
High
Medium
Likely
Perhaps it will happen sometime – has
infrequently occurred
Serious Injury
Quite serious injury/ illness involving some
days off work
Serious Injury
High
High
Medium
Medium
Unlikely
Could happen but would be unusual – no
previous incidents recorded
Harmful
Some first aid or minor medical attention,
but no lost time
Harmful
High
Medium
Medium
Low
Highly
Unlikely
Could happen but probably never will – never
occurred before
Negligible
Some discomfort, but no medical attention
needed
Negligible
Medium
Medium
Low
Low
Administrative Form - Safety Analysis Worksheet
Consequences
687317580
Version 01
Page 3 of 7
Business Unit: Probation and Parole Service – Graffiti Removal Program
Location: ALL COMMUNITY SERVICE PROJECTS
Activity/Task: Graffiti Removal with chemicals
Activity
Hazards
List the task required to perform the
activity in the sequence they are to
be carried out.
Against each task list the hazards that could
cause injury when the task is performed.
Decant chemicals from 25 litre
containers to 5 litre containers
Date:
Permit to work required: Yes/No
Initial risk
rating.
Controls measures
Residual
risk rating
Who is responsible?
Chemical spill by over filling container.
High
Wear PPE, follow local chemical spill procedures, ensure
spill kit is current and up to date and supervision of all filling
processes and training in safe handling of chemicals.
Medium
Supervisor
Decant chemicals from 5 litre
container to small 1 litre spray bottle
Chemical spill by over filling container.
Spilling on hands and eyes and using
incorrect or not labelled bottles
Medium
Wear PPE and unsure all bottles are labelled
Medium
Supervisor
Spray objects
Chemical spill by over filling container or
spray into eyes of self others
Medium
Wear PPE and ensure all offenders are instructed on the
safe use of chemicals and spray bottles.
Medium
Supervisor
Spraying of Smart Active product into water,
waterways.
Medium
Ensure all offenders are instructed on the safe use of
chemicals and spray bottles and contact EPA if incident
occurs.
Medium
Supervisor
Flicking chemicals into eyes or skin
Medium
Wear PPE and ensure all offenders are instructed on the
safe use brushes
Low
Supervisor
Used rags catch fire
Medium
Used rags are stored safely and ensure no smoking when
using chemicals or near trailer
Low
Supervisor
Wash objects with high pressure
hose/gurney
Misuse of hose and pointing it at another
person or object and Flying particles from
cleaning surface after spray fly into eyes
High
Users are instructed on how to use the hose & trigger and
users will be selected after offenders have shown ability and
responsibility to use equipment.
Medium
Supervisor
Decant spray bottles back to 5 litre
containers
Chemical spill by over filling container.
High
Wear PPE, follow local chemical spill procedures, ensure
spill kit is current and up to date and supervision of all fill
processes and training in safe handling of chemicals.
Medium
Supervisor
Wipe and brush objects
Consequence
Probability of Adverse Event or Incident during task
List the control measures required to eliminate or
minimise the risk of injury arising from the identified
hazard.
Probability
Write the name of the person responsible
(supervisor or above) to implement the control
measures identified
Consequences
Very Likely
Likely
Unlikely
Highly unlikely
Very Likely
Good chance it will happen – has sometimes occurred
before
Life Threatening
Very serious injury or life threatening
Life Threatening
High
High
High
Medium
Likely
Perhaps it will happen sometime – has infrequently
occurred
Serious Injury
Quite serious injury/ illness involving some days
off work
Serious Injury
High
High
Medium
Medium
Unlikely
Could happen but would be unusual – no previous
incidents recorded
Harmful
Some first aid or minor medical attention, but no
lost time
Harmful
High
Medium
Medium
Low
Highly
Unlikely
Could happen but probably never will – never
occurred before
Negligible
Some discomfort, but no medical attention needed
Negligible
Medium
Medium
Low
Low
Administrative Form - Safety Analysis Worksheet
687317580
Version 01
Page 4 of 7
Business Unit: Probation and Parole – Graffiti Removal Program
Location: ALL COMMUNITY SERVICE PROJECTS
Activity/Task: Continuously attending site with unknown risks
Activity
Hazards
List the task required to perform the
activity in the sequence they are to
be carried out.
Against each task list the hazards that could
cause injury when the task is performed.
Arriving and various and
differing work sites
Unknown
Consequence
Date:
Permit to work required: Yes/No
Initial risk
rating.
Controls measures
Unknown
Develop standard checklist for use prior to offenders
exciting the bus
List the control measures required to eliminate or
minimise the risk of injury arising from the identified
hazard.
Residual
risk rating
Who is responsible?
Unknown
Manager and Supervisor
Write the name of the person responsible
(supervisor or above) to implement the control
measures identified
Probability of Adverse Event or Incident during task
Probability
Very Likely
Likely
Unlikely
Highly unlikely
Very Likely
Good chance it will happen – has sometimes
occurred before
Life Threatening
Very serious injury or life threatening
Life Threatening
High
High
High
Medium
Likely
Perhaps it will happen sometime – has
infrequently occurred
Serious Injury
Quite serious injury/ illness involving some
days off work
Serious Injury
High
High
Medium
Medium
Unlikely
Could happen but would be unusual – no
previous incidents recorded
Harmful
Some first aid or minor medical attention,
but no lost time
Harmful
High
Medium
Medium
Low
Highly
Unlikely
Could happen but probably never will – never
occurred before
Negligible
Some discomfort, but no medical attention
needed
Negligible
Medium
Medium
Low
Low
Administrative Form - Safety Analysis Worksheet
Consequences
687317580
Version 01
Page 5 of 7
Business Unit: Probation and Parole – Graffiti Removal Program
Location: ALL COMMUNITY SERVICE PROJECTS
Activity/Task: Graffiti Removal with high pressure hose
Activity
Hazards
List the task required to perform the
activity in the sequence they are to be
carried out.
Against each task list the hazards that
could cause injury when the task is
performed.
Activate tank by turning handle
Nil
Turn motor on
Date:
Permit to work required: Yes/No
Residual
risk rating
Who is responsible?
Starts at waist height, make sure there is adequate
fuel before staring and if discomfort occurs stop
process and complete incident report
Low
Supervisor
Medium
Monitor and instruct offenders to keep a clear and
safe distance.
Medium
Supervisor
Motor catches fire through fault or
overfill
High
Follow motor operating instructions and ensure
regular maintenance occurs as per manufactures
instructions and ensure fire extinguisher working
order and is in date.
Medium
Supervisor
Unwind hose
Tripping someone with hose
Medium
Users are instructed on how to unwind the hose and
the hose use.
Low
Supervisor
Operate hose by pointing at site and using
hand trigger
Misuse of hose and pointing it at another
person or object
High
Users are instructed on how to use the hose &
trigger and users will be selected after offenders
have shown ability and responsibility to use
equipment.
Medium
Supervisor
Flying particles from cleaning surface
after spray fly into eyes
Medium
Wear goggles and gloves at all times
Low
Supervisor
Consequence
Initial
risk
rating.
Controls measures
Force of pulling motor starter may strain
shoulder or back
Low
Exhaust burning on pipe or inhaling
fumes
List the control measures required to eliminate or
minimise the risk of injury arising from the
identified hazard.
Write the name of the person responsible
(supervisor or above) to implement the control
measures identified
Probability of Adverse Event or Incident during task
Probability
Very Likely
Likely
Unlikely
Highly unlikely
Very Likely
Good chance it will happen – has sometimes
occurred before
Life Threatening
Very serious injury or life threatening
Life Threatening
High
High
High
Medium
Likely
Perhaps it will happen sometime – has
infrequently occurred
Serious Injury
Quite serious injury/ illness involving some
days off work
Serious Injury
High
High
Medium
Medium
Unlikely
Could happen but would be unusual – no
previous incidents recorded
Harmful
Some first aid or minor medical attention,
but no lost time
Harmful
High
Medium
Medium
Low
Highly
Unlikely
Could happen but probably never will – never
occurred before
Negligible
Some discomfort, but no medical attention
needed
Negligible
Medium
Medium
Low
Low
Administrative Form - Safety Analysis Worksheet
Consequences
687317580
Version 01
Page 6 of 7
Business Unit: Probation and Parole – Graffiti Removal Program
Location: ALL COMMUNITY SERVICE PROJECTS
Activity/Task: Graffiti Removal with chemicals
Date:
Permit to work required: Yes/No
Activity
Hazards
Against each task list the hazards that
could cause injury when the task is
performed.
Initial
risk
rating.
Controls measures
List the task required to perform the
activity in the sequence they are to
be carried out.
Residual
risk rating
Who is responsible?
Decant chemicals from 25 litre containers
to 5 litre containers
Chemical spill by over filling container.
High
Wear PPE, follow local chemical spill procedures, ensure spill
kit is current and up to date and supervision of all filling
processes and training in safe handling of chemicals.
Medium
Supervisor
Decant chemicals from 5 litre container
to small 1 litre spray bottle
Chemical spill by over filling container. Spilling
on hands and eyes and using incorrect or not
labelled bottles
Medium
Wear PPE and unsure all bottles are labelled
Medium
Supervisor
Spray objects
Chemical spill by over filling container or spray
into eyes of self others
Medium
Wear PPE and ensure all offenders are instructed on the safe
use of chemicals and spray bottles.
Medium
Supervisor
Spraying of Smart Active product into water,
waterways.
Medium
Ensure all offenders are instructed on the safe use of chemicals
and spray bottles and contact EPA if incident occurs.
Medium
Supervisor
Flicking chemicals into eyes or skin
Medium
Wear PPE and ensure all offenders are instructed on the safe
use brushes
Low
Supervisor
Used rags catch fire
Medium
Used rags are stored safely and ensure no smoking when using
chemicals or near trailer
Low
Supervisor
Wash objects with high pressure hose
Misuse of hose and pointing it at another person
or object and Flying particles from cleaning
surface after spray fly into eyes
High
Users are instructed on how to use the hose & trigger and users
will be selected after offenders have shown ability and
responsibility to use equipment.
Medium
Supervisor
Decant spray bottles back to 5 litre
containers
Chemical spill by over filling container.
High
Wear PPE, follow local chemical spill procedures, ensure spill
kit is current and up to date and supervision of all fill processes
and training in safe handling of chemicals.
Medium
Supervisor
Wipe and brush objects
Consequence
Probability of Adverse Event or Incident during task
List the control measures required to eliminate or
minimise the risk of injury arising from the identified
hazard.
Probability
Write the name of the person responsible
(supervisor or above) to implement the
control measures identified
Consequences
Very Likely
Likely
Unlikely
Highly unlikely
Very Likely
Good chance it will happen – has sometimes
occurred before
Life Threatening
Very serious injury or life threatening
Life Threatening
High
High
High
Medium
Likely
Perhaps it will happen sometime – has infrequently
occurred
Serious Injury
Quite serious injury/ illness involving some days
off work
Serious Injury
High
High
Medium
Medium
Unlikely
Could happen but would be unusual – no previous
incidents recorded
Harmful
Some first aid or minor medical attention, but no
lost time
Harmful
High
Medium
Medium
Low
Highly
Unlikely
Could happen but probably never will – never
occurred before
Negligible
Some discomfort, but no medical attention
needed
Negligible
Medium
Medium
Low
Low
Administrative Form - Safety Analysis Worksheet
687317580
Version 01
Page 7 of 7