RISK ASSESSMENT FORM |
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Shoot
date
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Production Title |
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Producer
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17/10/15
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Jealous type
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Sumaya
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Location:
One New Change, The Rooftop Terrace |
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Address: One New Change,
London,
EC4M
9AF
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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?
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Severity
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Likelihood
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Risk Factor
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1
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Alcohol/drugs
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Yes
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M
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VL
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3
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2
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Animals/insects
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Yes
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L
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P
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2
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3
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Audiences
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No
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4
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Camera
cable/grip equipment
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Yes
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S
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VL
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5
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5
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Confined
spaces
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No
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6
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Derelict
buildings/dangerous structures
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Yes
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VS
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P
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4
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7
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Electricity/gas
(other than normal supplies)
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No
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8
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Fatigue/long
hours
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Yes
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M
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P
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3
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9
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Fire/flammable
materials
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No
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10
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Hazardous
substances
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No
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11
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Heat/Cold/extreme
weather
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No
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12
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Laser/strobe
effects
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No
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13
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Machinery/industrial/
crane/hoist
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No
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14
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Materials
- glass, non-fire retardant set materials
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Yes
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S
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L
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3
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15
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Night
operation
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No
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16
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Noise
– high sound levels
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No
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17
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Non
standard manual handling
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No
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18
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Public/crowds
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Yes
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M
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P
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3
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19
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Radiation
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No
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20
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Scaffold/Rostra
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Yes
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VS
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P
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4
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21
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Smoking
on set
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No
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22
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Special
effects/explosives
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No
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23
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Special
needs (elderly, disabled, inexperienced)
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No
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24
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Specialised
rescue/first aid
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No
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25
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Stunts,
dangerous activities
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No
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26
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Tall
scenery/suspended ceilings
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Yes
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VS
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P
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4
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27
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Vehicles/speed
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No
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28
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Water/proximity
to water
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No
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29
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Weapons
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No
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30
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Working
at heights
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Yes
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VS
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P
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4
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31
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Working
overseas
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No
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32
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Other risks
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No
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Calculate
the Risk Factor:
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Very Unlikely |
Unlikely
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Possible
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Likely
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Very
Likely
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Very
severe
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3
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4
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4
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5
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5
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Severe
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2
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3
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3
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3
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5
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Moderate
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2
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2
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3
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3
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3
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Low
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1
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2
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2
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3
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3
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Negligible
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1
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1
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2
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2
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3
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Decide
the action to take:
5
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Very
severe
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Take
immediate action
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4
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Severe
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High
priority
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3
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Moderate
Risk
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Programme
for action
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2
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Low
Risk
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Action
may be required
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1
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Negligible
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Probably
acceptable
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Then list each risk identified
Hazard no:
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1
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Risk Factor (1-5):
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3
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Description
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There could be potential spillage.
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Person(s) exposed (detail if
cast/crew (C), outside company (O) or public (P) )
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Cast/ Crew
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Action to take
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Stay away from the Madison Bar and ensure that we are
filming away from the bar. If there is spillage then ensure that the
equipment is taken away quickly and ensuring that we don’t slip as the
surfaces in the location is slippery in some places.
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Person/company responsible for action
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Crew
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To be completed at agreed
later date
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Exposed person(s) informed? (y/n)
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y
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Agreed action taken? (y/n)
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y
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Risk removed? (y/n)
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Y
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Hazard no:
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2
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Risk Factor (1-5):
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1
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Description
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Could interfere with filming leading
to time wasting.
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Person(s) exposed (detail if
cast/crew (C), outside company (O) or public (P) )
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Cast/ crew
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Action to take
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Film in an area where there is no flies etc...
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Person/company responsible for action
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Crew
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To be completed at agreed
later date
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Exposed person(s) informed? (y/n)
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y
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Agreed action taken? (y/n)
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y
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Risk removed? (y/n)
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Y
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Hazard no:
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4
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Risk Factor (1-5):
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5
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Description
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Someone could potentially trip over
the equipment causing a problematic injury as some of the surfaces are
slippery. Also, due to this the equipment could stop working.
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Person(s) exposed (detail if
cast/crew (C), outside company (O) or public (P) )
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C,O,P
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Action to take
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Ensure that the equipment is visible to everyone and if
anyone is walking past take extra care that they don’t have contact with the
equipment.
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Person/company responsible for action
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Crew
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To be completed at agreed
later date
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Exposed person(s) informed? (y/n)
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Y
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Agreed action taken? (y/n)
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y
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Risk removed? (y/n)
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y
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Hazard no:
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6
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Risk Factor (1-5):
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5
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Description
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As we are all not familiar with the
location, we need to ensure that we don’t slip as it is does have slippery
surfaces. There is a risk of falling from these structures as they are very
high cause severe injury.
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Person(s) exposed (detail if
cast/crew (C), outside company (O) or public (P) )
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C,O,P
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Action to take
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Ensure that we are looking at the surfaces we are filming
at and ensure that we don’t go too close to the edges.
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Person/company responsible for action
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Crew
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To be completed at agreed
later date
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Exposed person(s) informed? (y/n)
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y
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Agreed action taken? (y/n)
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y
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Risk removed? (y/n)
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Y
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Hazard no:
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8
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Risk Factor (1-5):
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1
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Description
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As we are not familiar with the
location, there may be unforeseen changes that we might have to make.
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Person(s) exposed (detail if
cast/crew (C), outside company (O) or public (P) )
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Cast/ crew
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Action to take
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Ensure that we stick to our storyboard and if we
desperately need to change something then do so in a safe manner.
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Person/company responsible for action
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Crew
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To be completed at agreed
later date
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Exposed person(s) informed? (y/n)
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y
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Agreed action taken? (y/n)
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y
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Risk removed? (y/n)
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Y
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Hazard no:
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14
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Risk Factor (1-5):
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5
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Description
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As some of the surfaces are made of
glass, we could all potentially slip and cause injury to ourselves. Also, the
equipment could break.
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Person(s) exposed (detail if
cast/crew (C), outside company (O) or public (P) )
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Cast/ crew
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Action to take
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Ensure that we don’t film next to the glass to ensure that
we don’t encounter this risk.
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Person/company responsible for action
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Crew
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To be completed at agreed
later date
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Exposed person(s) informed? (y/n)
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Y
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Agreed action taken? (y/n)
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y
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Risk removed? (y/n)
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y
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Hazard no:
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18
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Risk Factor (1-5):
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2
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Description
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Could interfere with our filming
leading to time wasting and also, could steal/ break the equipment.
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Person(s) exposed (detail if
cast/crew (C), outside company (O) or public (P) )
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Cast/ Crew
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Action to take
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Try to film as quickly as possible without bringing
attention to ourselves and also keep an eye on the equipment at all times.
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Person/company responsible for action
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Crew
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To be completed at agreed
later date
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Exposed person(s) informed? (y/n)
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y
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Agreed action taken? (y/n)
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y
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Risk removed? (y/n)
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Y
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Hazard no:
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20
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Risk Factor (1-5):
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5
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Description
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As we are all not familiar with the
location, we need to ensure that we don’t slip as it is does have slippery
surfaces. There is a risk of falling from these structures as they are very
high cause severe injury.
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Person(s) exposed (detail if
cast/crew (C), outside company (O) or public (P) )
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C,O,P
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Action to take
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Ensure that we are looking at the surfaces we are filming
at and ensure that we don’t go too close to the edges.
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Person/company responsible for action
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Crew
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To be completed at agreed
later date
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Exposed person(s) informed? (y/n)
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y
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Agreed action taken? (y/n)
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y
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Risk removed? (y/n)
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Y
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Hazard no:
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26
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Risk Factor (1-5):
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5
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Description
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As we are all not familiar with the
location, we need to ensure that we don’t slip as it is does have slippery
surfaces. There is a risk of falling from these structures as they are very
high cause severe injury.
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Person(s) exposed (detail if
cast/crew (C), outside company (O) or public (P) )
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C,O,P
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Action to take
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Ensure that we are looking at the surfaces we are filming
at and ensure that we don’t go too close to the edges.
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Person/company responsible for action
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Crew
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To be completed at agreed
later date
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Exposed person(s) informed? (y/n)
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y
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Agreed action taken? (y/n)
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y
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Risk removed? (y/n)
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Y
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Hazard no:
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30
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Risk Factor (1-5):
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5
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Description
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As we are all not familiar with the
location, we need to ensure that we don’t slip as it is does have slippery
surfaces. There is a risk of falling from these structures as they are very
high cause severe injury.
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Person(s) exposed (detail if
cast/crew (C), outside company (O) or public (P) )
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C,O,P
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Action to take
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Ensure that we are looking at the surfaces we are filming
at and ensure that we don’t go too close to the edges.
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Person/company responsible for action
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Crew
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To be completed at agreed
later date
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Exposed person(s) informed? (y/n)
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y
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Agreed action taken? (y/n)
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y
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Risk removed? (y/n)
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Y
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Completed by: Jumana Yasmeen
Position: Director
Signature Jumana Yasmeen Date:
06/10/15
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