Risk Assessment Form Sue and Sarahs Interview and Sequences

Division / Studio Business Unit / Production Address UCA Maidstone Department / Series Producer / Editor Tel: Mobile: Start date Distribution Who gets a copy of the assessment Outline of risk assessment Summary of what is proposed Team members / experts / contractors / contributors etc. List those involved Locations Outline locations involved indicate any which are hostile environments Sues House 11 tickenhall drive Church langley way Harlow Essex CM17 9PF Sue, Sarah and Family. Maddie, Hennie and Dean Sit down interview, sequences of family interaction, sit down eating challenge 07/10/12 Helen Curston End date 07/10/12 Maddie Ireland and Hennie Clough

Assessor

Name Signature

Date completed

Authoriser (if not Assessor)

Name Signature

Helen Curston

Date authorised

Hazard list select your hazards from the list below and use these to complete Part B
Situational hazards
Assault by person Attack by animal Breathing compressed gas Cold environment Crush by load Drowning Entanglement in moving machinery High atmospheric pressure Hot environment Manual handling Object falling, moving or flying Obstruction / exposed feature Sharp object / material Shot by firearm Slippery surface Trap in moving machinery Trip hazard Vehicle impact / collision Falls from height

Tick

Physical / chemical hazards

Contact with cold liquid / vapour Contact with cold surface Contact with hot liquid / vapour Contact with hot surface Electric shock Explosive blast Explosive release of stored pressure Fire Hazardous substance Ionizing radiation Laser light Lightning strike Noise Non-ionizing radiation Stroboscopic light Vibration

Tick

Health hazards
Disease causative agent Infection Allergic reaction Lack of food / water Lack of oxygen Physical fatigue Repetitive action Static body posture Stress / anxiety Choking

Tick

Environmental hazards
Litter Nuisance noise / vibration Physical damage Waste substance released into air Waste substance released into soil / water

Managerial / organisational hazards

Management factors (lack of communication, co-operation, coordination and competence)

Risk matrix use this to determine risk for each hazard i.e. how
bad and how likely

Likelihood of Harm

Remote Severity of Harm

e.g. <1 in 1000 chance

Very unlikely
e.g. 1 in 200 chance

Unlikely
e.g. 1 in 50 chance

Possible
e.g. 1 in 10 chance

Likely
e.g. >1 in 3 chance

Negligible e.g. small bruise Slight e.g. small cut, deep bruise Moderate e.g. deep cut, torn muscle Severe e.g. fracture, loss of consciousness Very Severe e.g. death, permanent disability

Trivial

Trivial

Trivial

Low

Low

Trivial

Trivial

Low

Low

Medium

Trivial

Low

Medium

Medium

High

Low

Medium

High

High

Extremely high

Low

Medium

High

Extremely high

Extremely high

Risk Assessment Form Part B

Activity Each individual activity you are proposing: Sit down interview Location where this activity will take place: Sues House Dates / times:
9/11/11

Hazards
List what could cause harm from this activity e.g. falls from height, trip hazard, fire, etc.

Who exposed
List who might be harmed from this activity e.g. staff, contractors, contributors, public, etc.

Risk
For each hazard, decide level of risk as if you were to do the activity without your controls

Control measures
For each hazard, list the measures you will be taking to minimise the risk identified e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective equipment, provision of first aid, etc.

Risk
For each hazard, decide level of risk once all your controls are in place

Trip hazard

Subjects and crew

Low

One of us will cable bash so that no one trips over the cable

Trivial

Activity Each individual activity you are proposing: Family evening routine sequence

Location where this activity will take place: Sues House

Dates / times:
9/11/11

Hazards
List what could cause harm from this activity e.g. falls from height, trip hazard, fire, etc.

Who exposed
List who might be harmed from this activity e.g. staff, contractors, contributors, public, etc.

Risk
For each hazard, decide level of risk as if you were to do the activity without your controls

Control measures
For each hazard, list the measures you will be taking to minimise the risk identified e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective equipment, provision of first aid, etc.

Risk
For each hazard, decide level of risk once all your controls are in place

Trip hazard

Subjects and crew

Low

One of us will cable bash so that no one trips over the cable

Trivial

Activity Each individual activity you are proposing: Eating Challenge

Location where this activity will take place: Sues House

Dates / times:
15/11/11

Hazards
List what could cause harm from this activity e.g. falls from height, trip hazard, fire, etc.

Who exposed
List who might be harmed from this activity e.g. staff, contractors, contributors, public, etc.

Risk
For each hazard, decide level of risk as if you were to do the activity without your controls

Control measures
For each hazard, list the measures you will be taking to minimise the risk identified e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective equipment, provision of first aid, etc.

Risk
For each hazard, decide level of risk once all your controls are in place

Trip hazard Choking

Subjects and crew Subjects

Low Extremely High

One of us will cable bash so that no one trips over the cable Brief them to chew properly

Trivial Low