Sports Club: PERSON’s CONDUCTING THIS ASSESSMENT Name: Name: Name: Date risk assessment undertaken: Signature: Signature: Signature: ASSESSMENT REVIEW HISTORY This assessment should be reviewed immediately if there is any reason to suppose that the original assessment is no longer valid. Otherwise, the assessment should be reviewed annually. The responsible person must ensure that this risk assessment remains valid. Review 1 Review 2 Review 3 Review 4 Review 5 Review 6 Acceptable Y/N Risk L, M, H, VH What are you already doing (Existing Risk Control Measures) Risk Rating Who Might be Harmed and How? Severity What are the Hazards Likelihood Heading Hazard Ref No. Due date: Date conducted: Conducted by (1): Conducted by (2): Conducted by (3): Risk L, M, H Completion Date Risk Rating Target Date Severity Action By Likelihood Recommended Additional Risk Control Measures Implemented Y/N Revised Risk Risk Hazard Ref No. Identified Actions to Improve Control of Unacceptable Risks Revision of Risk Signed Off Guidance Document What are the Hazards? A hazard is anything with the potential to cause harm or ill health to people, or damage to property; Hazard Ref No. Hazards in number sequence starting at 1 Who might be harmed and how? For each hazard identified, decide which individuals or groups of people might be harmed, in what numbers and the type of injury or ill-health that might occur. What are you already doing? List systems and procedures that are currently in operation to reduce the hazard Criteria for Determining Risk Rating and Required Action Likelihood The likelihood of harm arising from a particular hazard is determined using the following criteria: Score Very Unlikely: Unlikely: Possible: Likely: Very Likely: May occur only in exceptional circumstances. May occur given an unlikely sequence of events and/or multiple failures. Foreseeable under normal circumstances – a known past incident may have occurred. Easily foreseeable under normal circumstances. Inevitable under the circumstances – known past incidents may have occurred. 1 2 3 4 5 Severity The severity of harm arising from a particular hazard is determined using the following criteria: Score No injury/pain or minor injury not requiring first aid. 1 Minor injuries requiring first aid e.g. cuts and bruises. No lasting effects. 2 Up to 3 days absence, flesh wound, bruising etc. 3 Requires over 3 days off work or a hospital visit. Reportable to HSE. 4 Single or multiple fatality, long term disability, loss of limb. 5 Risk Rating & Required Action Having estimated the likelihood and severity of a hazard, multiply the two values together to determine the Risk Rating, or use this matrix. Then, decide on further action, as illustrated by the table below: Insignificant: Minor: Moderate: Major: Fatal: Risk Rating & Required Action Having estimated the likelihood and severity of a hazard, multiply the two values together to determine the Risk Rating, or use this matrix. Then, decide on further action, as illustrated by the table below: Severity 5 4 3 2 1 5 4 3 2 1 1 10 8 6 4 2 2 15 12 9 6 3 3 20 16 12 8 4 4 25 20 15 10 5 5 Likelihood A Guide to Required Action Risk Rating Risk 17-25 Very high (VH) 10-16 High (H) 4-9 Medium (M) 1-3 Low (L) Risk L, M, H, VH As above guidance indicate level of risk Acceptable Y / N Indicate if hazard acceptable Identified Actions to Improve Control of Unacceptable Risk (Note: Assessors may propose more stringent actions depending on the circumstances) Stop work activity immediately and make improvements to risk controls. Improve risk control measures, within a specified timescale. Plan to improve risk control measures at time of next review, or sooner. No further action, but ensure risk control measures remain effective.