Risk Assessment Licensing Officer Last Risk Assessment Last Routine Hazard Rating at Final Risk
Date Initial Date Insp. Date Last Inspection Rating
Review
DD / MMM / YYYY DD / MMM / YYYY DD / MMM / YYYY _____ /65
TOTAL: /65
To ensure the risk assessment tool is providing correct information to others who may view it, licensing officers should include
a brief narrative description of the identified risks for every category that scores 3, 4 or 5. These reports are computer
generated and the scoring is done automatically to assign a risk score, thus a risk rating (low, moderate or high). If a facility
borders these risk rating or it is assessed by the licensing officer that a different risk rating should be assigned, the licensing
officer may collaborate with colleagues, review historical and new information and if deemed necessary override the automatic
category of risk rating given. If this is done it is essential that the licensing officer performing the risk assessment provide a
brief overview as to the reasons for the rating change.