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Health And Risk Assessment Checklist

This procedure will help in identifying the hazard(s) in the work place, assess the level of risk and how to control it. This assessment is conducted to establish whether there are any underlying health conditions that could be prevented or managed, to improve the quality of life and overall health of the employees. Use this template to document a risk assessment to manage health and safety hazards and risks.
Groeneveld-Beka
08/24/2022

Health And Risk Assessment Checklist

This procedure will help in identifying the hazard(s) in the work place, assess the level of risk and how to control it. This assessment is conducted to establish whether there are any underlying health conditions that could be prevented or managed, to improve the quality of life and overall health of the employees. Use this template to document a risk assessment to manage health and safety hazards and risks.
  • Activity Description:

  • Conducted By:

  • Date:

  • Step 1: Identify the Hazards

  • Chemicals (note: refer to the label and safety data sheet (SDS) for the classification and management of all chemicals)

  • Name of chemical(s) details:

  • Critical Incident -resulting in:

  • Other/details:

  • Energy systems -incident/issues involving:

  • Other/details:

  • Environment:

  • Other/details:

  • Facilities/Built Environment:

  • Other/details:

  • Machinery, plant and equipment:

  • Other/details:

  • Manual tasks/ergonomics:

  • Other/details:

  • People:

  • Other/details:

  • Other hazard details:

  • Step 2: Assess the Level of Risk

  • Consider the hazards identified in Step One and use the risk assessment matrix below as a guide to assess the risk level.

  • Screenshot2021-05-29at9.14.36AM.png
  • Consequence

  • Description of Consequence

  • Likelihood

  • Description of Likelihood

  • Assessment Risk Level

  • Description of Risk Level

  • Actions per Risk Level

  • Step 3: Control the Risk

  • In the table below:

  • Note: control measures should be implemented in accordance with the preferred hierarchy of control. If lower level controls (such as administration or PPE) are to be implemented without higher level controls, it is important the reasons are explained.

  • Screenshot2021-05-29at10.05.40AM.png
  • Hazards/risks and control measures

  • Description of hazards/risks

  • Risk Level

  • Control measures (Note: if only administration or PPE controls are used, please explain why)

  • Submission

  • This activity will be conducted in accordance with the risk assessment, implementing the control measure outlined in Step 3. Changes will be made to the activity if it is required to manage any emerging risks to ensure safety.

  • Contact Person: (indicate those others involved in the preparation of this risk assessment)

  • Date:

  • Step 4: Monitor and Review Controls

  • Complete during and/or after the activity

  • Are the planned control measures sufficient and effective in minimizing the level or risk?

    • Yes
    • No
    • N / A
  • Have there been any changes to the planned control measures?

    • Yes
    • No
    • N / A
  • Are further control measures required in future?

    • Yes
    • No
    • N / A
  • Details:

  • Review completed by:

  • Designation:

  • Signature:

    Click here to sign
  • Date:

Source: Groeneveld-Beka (Community Member)

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