Student Risk Assessment Summary Form (example) This document is to be referenced against the Workplace Learning Procedures 2016 to section 2.8) To be completed for student placement Download Blank Form Records of student risk assessment should be retained with work placement documentation (see Section 9 of the Workplace Learning Procedures 2016) School: Staff: Date: Group/Class/Program: Mitigating Strategies Hazard Identification Risk Assessment Approval Outcome (for medium, high and extreme risk level) Context Mitigation Strategy student profile, workplace profile Specific hazard New risk Conditional Actions/Requirements Date level student or workplace Assumes an appropriate workplace preparation program has been undertaken Student Workplace level Consequence Risk Likelihood Student A All in retail All have the capacity to work Minor Unlikely Low Nothing additional needed Low Placement approved Student B Clothes and safely in chosen retail Student C apparel environment Student D Manufacturing Has hearing impairment Moderate Likely High Additional WH&S: Moderate Placement approved conditional to further Office setting Consult Disability Services; inform negotiated strategies with workplace provider to Reception workplace host; inform parent support student (see attached) duties
Student Risk Assessment Summary Form (example) This document is to be referenced against the Workplace Learning Procedures 2016 to section 2.8) To be completed for student placement Download Blank Form Records of student risk assessment should be retained with work placement documentation (see Section 9 of the Workplace Learning Procedures 2016) School: Staff: Date: Group/Class/Program: Hazard Identification Risk Assessment Mitigating Strategies (for medium, high and extreme risk level) Approval Outcome Context student profile, workplace profile Specific hazard student or workplace Consequence Likelihood Risk level Mitigation Strategy Assumes an appropriate workplace preparation program has been undertaken New risk level Conditional Actions/Requirements Date Student Workplace Student A Student B Student C All in retail Clothes and apparel All have the capacity to work safely in chosen retail environment Minor Unlikely Low Nothing additional needed Low Placement approved Student D Manufacturing Office setting Reception duties Has hearing impairment Moderate Likely High Additional WH&S: Consult Disability Services; inform workplace host; inform parent Moderate Placement approved conditional to further negotiated strategies with workplace provider to support student (see attached)
WPLG_Final_26AUG_2016_moodle.docx