Activity / Event: ……………………………………. Date: ……………….. Time: …………… Program: …………………………………… Detail of Activity Event: ……………………………………………………………………………. Location: …………………………………... Control Measures Implemented? Control Measures (Actions taken Person Responsible Activity / Hazard Risk Factors Risk Rating for prevention) for Control Yes No Likelihood Consequences All staff to be in uniform with Staff Identification and Blue Cards visible. Signed: ……………………………………….. Activity Leader Signed: Signed: ………………………………………… ………………………………………… Dated: ……………. Manager Workplace Health and Safety Adviser All incidents to be reported on Doc0012 Incident Report form.
Activity / Event: ……………………………………. Date: ……………….. Time: …………… Program: …………………………………… Detail of Activity Event: ……………………………………………………………………………. Location: …………………………………... Activity / Hazard Risk Factors Likelihood Consequences Risk Rating Control Measures (Actions taken for prevention) Person Responsible for Control Control Measures Implemented? Yes No All staff to be in uniform with Staff Identification and Blue Cards visible. Signed: ……………………………………….. Activity Leader Signed: ………………………………………… Signed: ………………………………………… Dated: ……………. Manager Workplace Health and Safety Adviser All incidents to be reported on Doc0012 Incident Report form.
WHS%20Risk%20Assessment%20Plan.docx