RISK ASSESSMENT FORM
Shoot date		Production Title		Page            of
		Producer

                                                                               

Location:
Address:

RATINGS:

·          each risks severity on scale from Negligable (N), Low risk (L), Moderate risk (M), Severe (S), Very severe (V)

·          each risks likelihood on scale from Very unlikely (VU), Unlikely (U), Possible (P), Likely (L), Very likely (VL)

·         risk factor from the table overleaf.

Hazard		Present?	Severity	Likelihood	Risk Factor
1	Alcohol/drugs	NO
2	Animals/insects	NO
3	Audiences	NO
4	Camera cable/grip equipment	YES	L	U	2
5	Confined spaces	YES	L	U	2
6	Derelict buildings/dangerous structures	NO
7	Electricity/gas (other than normal supplies)	NO
8	Fatigue/long hours	NO
9	Fire/flammable materials	NO
10	Hazardous substances	NO
11	Heat/Cold/extreme weather	NO
12	Laser/strobe effects	NO
13	Machinery/industrial/ crane/hoist	NO
14	Materials - glass, non-fire retardant set materials	YES	L	U	2
15	Night operation	YES	L	U	2
16	Noise – high sound levels	NO
17	Non standard manual handling	NO
18	Public/crowds	YES
19	Radiation	NO
20	Scaffold/Rostra	NO
21	Smoking on set	NO
22	Special effects/explosives	NO
23	Special needs (elderly, disabled, inexperienced)	NO
24	Specialised rescue/first aid	NO
25	Stunts, dangerous activities	NO
26	Tall scenery/suspended ceilings	NO
27	Vehicles/speed	NO
28	Water/proximity to water	NO
29	Weapons	NO
30	Working at heights	NO
31	Working overseas	NO
32	Other risks	NO

Calculate the Risk Factor:

	Very Unlikely	Unlikely	Possible	Likely	Very Likely
Very severe	3	4	4	5	5
Severe	2	3	3	3	5
Moderate	2	2	3	3	3
Low	1	2	2	3	3
Negligible	1	1	2	2	3

Decide the action to take:

5	Very severe	Take immediate action
4	Severe	High priority
3	Moderate Risk	Programme for action
2	Low Risk	Action may be required
1	Negligible	Probably acceptable

Then list each risk identified

Hazard no: 4			Risk Factor (1-5): 2
Description	Camera cable/ grip equipment
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )	Whole cast
Action to take	Make sure we roll the wires up. We have to make sure it’s safe so it does not get stolen. Make sure the tripod does not stick out so people do not trip over it.
Person/company responsible for action	Whole cast
To be completed at agreed later date
Exposed person(s) informed? (y/n)	y	Agreed action taken? (y/n)		y	Risk removed? (y/n)		Y

Hazard no: 5			Risk Factor (1-5): 2
Description	Confined spaces in a bedroom
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )	Whole cast
Action to take	Make sure that we use up the space wisely so that people do not drop over the equipment and the actual film is effectively shot.
Person/company responsible for action	Whole cast
To be completed at agreed later date
Exposed person(s) informed? (y/n)	y	Agreed action taken? (y/n)		y	Risk removed? (y/n)		Y
Hazard no: 14			Risk Factor (1-5): 2
Description	Materials - glass, non-fire retardant set materials. Things like the jester mask, the bed covers e.t.c.
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )	Whole cast
Action to take	Make sure none of the materials are left alone where they can catch fire. Make sure we do not place them in hot areas or near flammable products
Person/company responsible for action	Whole cast
To be completed at agreed later date
Exposed person(s) informed? (y/n)	Y	Agreed action taken? (y/n)		y	Risk removed? (y/n)		y

Hazard no: 15			Risk Factor (1-5): 2
Description	Night operation. We will be filming around sunset and after sunset.
Person(s) exposed (detail if cast/crew (C), outside company (O) or public (P) )	Whole cast.
Action to take	Make sure we film around lights which wouldn’t be that much of a problem because we are filming in London where there are lights on almost every street. We can make sure we stay together during film.
Person/company responsible for action
To be completed at agreed later date
Exposed person(s) informed? (y/n)	y	Agreed action taken? (y/n)		y	Risk removed? (y/n)		Y

Completed by: Zakariya, Geoffrey, Luqman                    Position: Cast

Signature                                                                      Date: