Professional Year Program

Assessment Task 1.3 WHS Hazard & Risk Identification Report

Cover Sheet
Unit of
Competency:

BSBWHS401 Implement and monitor WHS policies, procedures

and programs to meet legislative requirements

Topic:

Topic 1 Australian Workplace Culture

Assessment
Task:

Task 1.3 - WHS Hazard & Risk Identification Report

Assessment Due
Date:

Week 4

Duratio
n:

3 hours

Assessment Criteria:
BSBWHS401:
applying organisational WHS management systems and procedures in the work team area
applying procedures for assessing and controlling risks to health and safety associated with
those hazards, according to the hierarchy of control and as specified in commonwealth and
state or territory WHS Acts, regulations and codes of practice
providing specific, clear and accurate information and advice on workplace hazards to work
team
knowledge of legal responsibilities of managers, supervisors, PCBUs or their officers and
workers in the workplace.
Assessment Instructions to Student:

Write your name as it appears on your enrolment form in the appropriate area on this
form

Attempt all questions in the assessment.

All answers to be typed using Microsoft Word
Use complete sentences, check grammar, punctuation and spelling

This assessment cover sheet must be handed in with your answers.

Resources permitted during assessment:

Dictionaries: Standard, Bilingual, Digital

Electronic devices: Laptops, Computers, Internet
Additional Assessment Instructions to Assessor:
Reasonable adjustment: Trainers may make reasonable allowances for learners in accordance
with the C&I Learner Support Policy contained in the Participant and Trainer Handbooks. This
may relate to the timeframe for undertaking this assessment task in class or relate to an
extension to the due date. Consult with the Curriculum & Learning Manager prior to
administering this assessment to ensure Learner Support needs are met.

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Professional Year Program

Assessment Task 1.3 WHS Hazard & Risk Identification Report
The following activities contain questions regarding Work Health & Safety. The WHS Reporting
Documents (including Hazard Checklist, Incident & Injury Report, Risk assessment and Control
and Monitoring forms are all provided below) and can be completed during class following the
criteria below: Please refer to relevant legislation when outlining your recommended actions.
1. Complete a Hazard Checklist using the classroom facility/building as a simulated workplace
environment.
2. Based on the completed Hazard Checklist, choose one hazard and create a hypothetic
incident based on this hazard. From this incident, complete an Incident/Injury Report.
3. Based on the Hazard checklist and Incident report you have now completed, complete a
Risk Assessment based on the hazard & incident you choose.
4. Based on the Hazard checklist, Incident Report and Risk Assessment, complete the Control
& Monitoring Form.

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Assessment Task 1.3 WHS Hazard & Risk Identification Report

Hazard Checklist

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Assessment Task 1.3 WHS Hazard & Risk Identification Report

Participant
Name:
Date:
Element:
1.

Yes

No

N/A

Action required

LAYOUT

Area is tidy and well kept

Floor is free of obstructions
Aisles are free from obstructions
Floor coverings are in good condition
2.

ENVIRONMENT

Temperature is comfortable
Lighting is adequate
Area is free from odours
Noise level is acceptable
Ventilation
is adequate
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Assessment Task 1.3 WHS Hazard & Risk Identification Report

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Assessment Task 1.3 WHS Hazard & Risk Identification Report

Incident/Injury Report
Outcome of incident:
Near Miss

Injury

Property Damage

1. Details of person involved

Name:
Male

Gender:

Female

Date of Birth:

Address:
Email:
Mob Phone:

Home Phone:

Position:

Employee

Employment Status:

Full Time

Job Role:

Contractor

Visitor

Part Time

Volunteer
Casual

Experience in the job:

2. Details of incident
Date:

Time:

Location:
Describe what happened and how it
occurred:

3. Details of injury

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Assessment Task 1.3 WHS Hazard & Risk Identification Report

Nature of injury (eg burn, cut, sprain):

Cause of injury (eg fall, grabbed by person
):
Location on body (eg back, left forearm):
Agency (eg lounge chair, another person,
hot water):

4. Treatment administered
Yes

First Aid Given

No

First Aider Name:

Treatment:
Referred to:

5. Did the injured person stop work?

Yes

No

If yes, state lost time (days):

Outcome:
Treated
by:Doctor

Hospitalised

Workers
compensation
claim

Returned to
normal work

Alternative
duties

Rehabilitation

6. Details of witness
Were
there
any Yes
witnesses?
If Yes, complete the information below:

No

Witness Name:
Mobile Phone

Home Phone:

Email:
Address:

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Assessment Task 1.3 WHS Hazard & Risk Identification Report

7. Incident investigation
Comments to include causal factors, add extra sheets if needed:

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Assessment Task 1.3 WHS Hazard & Risk Identification Report

Risk Assessment Form

1. Hazard identification

Describe the hazard

Identify the potential risk

2. Assess the risk

Potential risk
Impact

Rare

Unlike
ly

Possibl
e

Likely

Almost
certain

Catastrophic

Major

Moderate

Minor

VL

VL

Insignificant

IMPACT:

How severely could someone be hurt

Catastrophic

Death or permanent disability to one or more persons

Major

Hospital admission required

Moderate

Medical treatment required

Minor

First aid required

Insignificant

Injuries not requiring first aid

LIKELIHOOD:

How likely are those consequences?

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Assessment Task 1.3 WHS Hazard & Risk Identification Report

Almost certain

Expected to occur in most circumstances

Likely

Will probably occur in most circumstances

Possible

Could occur at some time

Unlikely

Is not likely to occur in normal circumstances

Rare

May occur only in exceptional circumstances

Risk level

Required action
Act immediately:
The proposed task or process activity must not proceed. Steps must be taken to
lower the risk level to as low as reasonably practicable using the hierarchy of risk
controls.

Critical (C)

Act today:
The proposed activity can only proceed, provided that:
(i) the risk level has been reduced to as low as reasonably practicable using
the hierarchy of risk controls;
(ii) the risk controls must include those identified in legislation, Standards,
Codes of Practice etc.
(iii) the risk assessment has been reviewed and approved by the Supervisor
and
(iv) The supervisor must review and document the effectiveness of the
implemented risk controls.

High (H)

Act this week:

Medium (M)

The proposed task or process can proceed, provided that:

(i) the risk level has been reduced to as low as reasonably practicable using
the hierarchy of risk controls;
(ii) the risk assessment has been reviewed and approved by the Supervisor.
Act this month:

Low (L)

Managed by local documented routine procedures which must include

application of the hierarchy of controls.
Keep a watching brief:

Very Low (VL)

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Although the risk level is low the situation should be monitored periodically to
determine if the situation changes.

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Assessment Task 1.3 WHS Hazard & Risk Identification Report

Control & Monitoring Form

Action to prevent recurrence
Level of control

Short term controls

Who/when

Long-term controls

Who/when

Eliminate the hazard remove

it completely from your
workplace
Substitute the hazard with a
safer alternative

Isolate the hazard as much

as possible away from workers

Use engineering controlsadapt tools or equipment to

reduce the risk
Use administrative controls
change work practices and
organization
Use personal protective
equipment (PPE) this should
be the last option after
considering all other options
2. Monitor and review
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Assessment Task 1.3 WHS Hazard & Risk Identification Report

Potential Hazard(s) to Monitor & Review

Review date

Person to Reviewed
(Name)

Any Further Comments/Information to report:

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