Risk Assessment Form Part A

Reference:

[enter reference number]]

Sign-off status

Blank Template

[planning/approved etc]

Assessment summary details

Assessment title *
(Simple name for reference
purposes)
Division:*

Department:*

Series/ Prod/Unit:

Programme/Area:

Responsible
Manager:

Contact office:

Address/Tel:

Address/Tel:

Date assessment created

Confidential risk
assessment?

YES/NO (delete as applicable)

Assessment Outline
(Summary of what is
proposed)
Assessment start
date

Review / End date

Country location

Hostile / travel
advisory?

Location details

NB: If the country location selected is Hostile you are

required to: complete the BBC Overseas High Risk
Assessment Form

Crew / team
(Roles, responsibilities,
competencies)
Attachments
(Detail supporting
documents)
Assessor(s)

Assessor safety
competence

(Person drafting risk

assessment)

Date signed-off *

Authoriser(s) *
(Person responsible for
sign-off)
Distribution
(Who gets a copy of the
assessment)

Data Protection Act: Personal information collected for the purposes of risk assessment will be used to identify those at risk, and
those involved in controlling risk, from this or similar activities and to fulfil the BBC's obligations under Health and Safety policy and
legislation. It will be retained for up to 6 years after the expiry of the activity. It may be shared with other organisations, including
our agents and contractors, with whom the risk or the control of risk is shared.

Activity and Hazard Summary

Activity

[This is a summary of the activities listed in part B of the risk assessment.]

Who Exposed

Hazards{hazard titles

Activity Risk Rating

Comments log
Who by

Date / time
received

[* mandatory fields]

Comments

Assessor response

Date/ time
responded

Risk Assessment Form Part B

Reference:

Sign-off status

[enter reference number]]

ACTIVITIES:
What are you doing, where, for how long and who will be
involved? Complete the fields in the form below).

Blank Template

[planning/approved etc]

HAZARDS & CONTROLS:

How could someone become hurt or made ill and
how are you going to prevent this from happening?

Activity Title:*

Cords on the floor.

Activity Description:

The crew could trip over the cords and Injury themselves or others.

List those managing

this Activity and their
competence:

Holly Littlefair, (floor Manager), she says she will be able to do this, she will remind everyone on set about the wires and will put down tape or
rubber mats on the wires so that there is less of a risk of this happening.

Who & how many are

at risk from this
Activity?

Anyone on set is at risk of this activity.

Hazards
How could someone become hurt or made ill

Control measures
How are you going to prevent this from happening?

If they are running on set.

Tell everyone that running on set is prohibited.

Risk Level*: After your controls have been applied what is your assessment of the risk level of
this activity?

Add additional activities as required by copying this section and pasting below

[* mandatory fields]

Low

Risk Assessment Form Part B

Reference:

Sign-off status

[enter reference number]]

ACTIVITIES:
What are you doing, where, for how long and who will be
involved? Complete the fields in the form below).

Blank Template

[planning/approved etc]

HAZARDS & CONTROLS:

How could someone become hurt or made ill and
how are you going to prevent this from happening?

Activity Title:*

The Lights on set may over heat and catch fire.

Activity Description:

If someone leaves the lights on thoughout the day then the light may over heat and catch fire, this may injury someone
underneath the lights.

List those managing

this Activity and their
competence:

Ritee Kebla, she will be in charge of turning the lights on and off so that the risk does not happen, she is confident that she can do this.

Who & how many are

at risk from this
Activity?

All the people that stand under the lights or if the lights do catch on fire, everyone in the studio.

Hazards
How could someone become hurt or made ill

Control measures
How are you going to prevent this from happening?

If the lights are left on unsupervised and for a long time then
the lights I the studio may catch fire due to overheating.

Ritee will monitor the lights regularly so that if she sees that the light have been on to lobng then she
will turn them off!

Risk Level*: After your controls have been applied what is your assessment of the risk level of
this activity?

[* mandatory fields]

Low