Risk Assessment No:
Issue:
Task:
Signature &
Position:
Company Name:
Probability
Severity
5
4
3
2
1
5
4
3
2
1
Relevant legislation
This list is not exhaustive
The following guidelines should be applied to risk factors after control measures have been applied:
Risk Factor = Probability x Severity
Low Risk = 1 to 6
Medium = 7 to 11
High = 12 +
Fatality
Major Injury
Medical Injury
Minor Injury
No Injury
Risk factor after control measures: 1 – 6
OK to proceed
Risk factor after control measures: 7 – 11
Further control measures should be applied. Seek further advice if unsure.
Risk factor after control measures: 12+
Unacceptable – Do not proceed
Health and Safety at Work Etc. Act 1974
Management of Health and Safety at Work Regulations 1999 (as amended)
Manual Handling Operations Regulations 1992 (as amended)
Control of Substances Hazardous to Health Regulations 2002 (as amended)
Risk Factor Before Control:
Probability
Risk:
Date:
Control Measure
Provision and Use of Work Equipment Regulations 1998
Lifting Operations and Lifting Equipment Regulations 1998
Personal Protective Equipment Regulations 1992
Workplace (Health, Safety, Welfare) Regulations 1992 (as amended)
Risk Factor After Control:
5
5
4
4
Probability
Very Likely
Likely
Probable
Possible
Very Unlikely
Hazard:
©Cope Safety Management 2012
www.jwcope.co.uk
Risk Assessment
RAF4 Rev2
3
2
1
0
3
2
1
1
2
3
4
5
0
1
2
Severity
Risk Factor Before Control:
Control Measure
5
5
4
4
3
2
1
0
4
5
4
5
Risk Factor After Control:
Probability
Risk:
Probability
Hazard:
3
Severity
3
2
1
1
2
3
Severity
4
5
0
1
2
3
Severity
Page 1 of 4
Risk Factor Before Control:
Control Measure
Risk Factor After Control:
5
5
4
4
Probability
Risk:
Probability
Hazard:
3
2
1
0
3
2
1
1
2
3
4
5
0
1
2
Severity
Control Measure
5
4
4
3
2
1
1
2
3
4
5
0
1
2
Control Measure
4
Probability
5
4
3
2
2
3
4
5
0
1
2
3
5
Severity
Control Measure
Risk Factor After Control:
5
5
4
4
Probability
Probability
4
2
1
1
Risk Factor Before Control:
3
2
1
0
5
3
Severity
Risk:
4
Risk Factor After Control:
1
Hazard:
3
Severity
5
0
5
2
1
Risk Factor Before Control:
Probability
Risk:
4
3
Severity
Hazard:
5
Risk Factor After Control:
5
0
4
Severity
Risk Factor Before Control:
Probability
Risk:
Probability
Hazard:
3
3
2
1
1
2
3
Severity
4
5
0
1
2
3
Severity
Page 2 of 4
Risk Factor Before Control:
Control Measure
Risk Factor After Control:
5
5
4
4
Probability
Risk:
Probability
Hazard:
3
2
1
0
3
2
1
1
2
3
4
5
0
1
2
Severity
Control Measure
5
4
4
3
2
1
1
2
3
4
5
0
1
2
3
4
5
Severity
Control Measure
Risk Factor After Control:
5
4
4
Probability
5
3
2
1
0
5
2
1
Risk Factor Before Control:
Probability
Risk:
4
3
Severity
Hazard:
5
Risk Factor After Control:
5
0
4
Severity
Risk Factor Before Control:
Probability
Risk:
Probability
Hazard:
3
3
2
1
1
2
3
4
5
0
1
2
Severity
3
Severity
This risk assessment accurately defines the work, identifies Health and Safety risks and the appropriate controls required. This risk assessment will be taken as approved by the Company
unless the author is advised to the contrary before work commences and in any event a period not exceeding 7 days from receipt.
This risk assessment must be communicated to all personnel concerned. Signatures confirming receipt and understanding of information are required.
CSM027/01
Page 3 of 4
RAF4 Risk Assessment Progress and Review Sheet
Risk Assessment No:
Company Name:
Issue:
Task:
Date:
Details of Progress Made:
Initials:
Date:
Details/Reason for Review:
Initials:
Page 4 of 4