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Risk Assessment Form –
Part A
Production Name: Better Health Campaign TV
Advert
Organisation Sunderland College
Production Address: Bede Campus, Durham Rd,
Sunderland SR3 4AH
Producer / Editor
Tel:
Mobile:
Dylan Brown
Details on file
Details on file
Start date 12/12/22 End date 14/12/22
Distribution
Who gets a copy of the assessment
N/A
Outline of risk assessment
Summary of what is proposed in
terms of sequences and set ups.
Single camera shoot (hand held and tripod). Shots will include different exercises either at the gym indoors
or outdoors in a park or other exercising facilities.
Team members / experts /
contractors / contributors etc.
List those involved
S. Cotton, S. Marshall (actors)
L. Braley (Cameraman)
Locations
Outline locations involved – indicate
any which are hostile environments
Sunderland College – Gym
Barnes Park, Sunderland
Goals Sunderland
Assessor Name
Signature
Date completed
Authoriser Name
(if not Assessor) Signature
Date authorised
Hazard list – select your hazards from the list below and use these to complete Part B
Situational hazards Tick Physical / chemical hazards Tick Health hazards Tick
Assault by person Y Contact with cold liquid / vapour Disease causative agent
Attack by animal Y Contact with cold surface Y Infection Y
Breathing compressed gas Contact with hot liquid / vapour Allergic reaction Y
Cold environment Y Contact with hot surface Lack of food / water
Crush by load Y Electric shock Lack of oxygen
Drowning Y Explosive blast Y Physical fatigue Y
Entanglement in moving machinery Explosive release of stored pressure Repetitive action
High atmospheric pressure Fire Y Static body posture
Hot environment Hazardous substance Y Stress / anxiety Y
Manual handling Ionizing radiation Venom poisoning Y
Object falling, moving or flying Y Laser light
Obstruction / exposed feature Lightning strike Y Environmental hazards
Sharp object / material Y Noise Y Litter Y
Shot by firearm Y Non-ionizing radiation Nuisance noise / vibration Y
Slippery surface Y Stroboscopic light Physical damage Y
Trap in moving machinery Vibration Y Waste substance released into air
Trip hazard Y Waste substance released into soil / water
Vehicle impact / collision Y Managerial / organisational hazards
Falls from height Y Management factors (lack of communication,
co-operation, co-ordination and competence)
Y
Risk matrix – use this to determine risk for
each hazard i.e. ‘how bad and how likely’ Likelihood of Harm
Severity of Harm
Remote
e.g. <1 in 1000 chance
Very unlikely
e.g. 1 in 200 chance
Unlikely
e.g. 1 in 50 chance
Possible
e.g. 1 in 10 chance
Likely
e.g. >1 in 3 chance
Negligible e.g. small bruise Trivial Trivial Trivial Low Low
Slight e.g. small cut, deep bruise Trivial Trivial Low Low Medium
Moderate e.g. deep cut, torn muscle Trivial Low Medium Medium High
Severe e.g. fracture, loss of consciousness Low Medium High High Extremely high
Very Severe e.g. death, permanent disability Low Medium High Extremely high Extremely high
Risk Assessment Form – Part B
Activity1
– Each individual activity you are proposing:
Running
Location – where this activity will take place:
Barnes Park, Sunderland
Dates / times:
Hazards2
List what could cause harm from this activity
e.g. falls from height, trip hazard, fire, etc.
Who exposed
List who might be harmed
from this activity
e.g. staff, contractors,
contributors, public, etc.
Risk3
For each hazard, decide
level of risk as if you were to
do the activity without your
controls
Control measures
For each hazard, list the measures you will be taking to minimise the risk identified
e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective
equipment, provision of first aid, etc.
Risk3
For each hazard,
decide level of risk
once all your controls
are in place
Attack by animal Public, Staff,
Contributors
Unlikely / Severe I will make sure that the area is clear of animals and make sure no animal are near the area
of shooting. If a animal comes near the shooting area, I will tell the owner (if they have one)
to move it away.
Very unlikely /
Moderate
Vehicle impact / collision Public, Staff,
Contributors
Unlikely / Severe I will not record near the road and make sure there are no vehicles around the shooting area.
If there is a vehicle heading towards the shooting area, I will tell everyone to move out the
way and everyone will be safe.
Very Unlikely /
Moderate
Trip hazard Public, Staff,
Contributors
Possible / Moderate Before shooting the shot that I am going to take, I will make sure the path is cleared of any
trip hazards so the actor that is in the shot, does not trip. For the surrounding areas too, I will
make sure there are no other trip hazards for the public or contributors/staff.
Unlikely / Slight
Slippery surface Public, Staff,
Contributors
Possible / Moderate Before we shoot on the day, I will make sure the environment is dry and clear and will not
cause any issues or health/injury problem when shooting.
Unlikely/
Moderate
Continue on separate sheet if necessary
1 – complete separate table for each activity 2 - from hazard list in Part A 3 - from risk matrix in Part A
Risk Assessment Form – Part B
Activity1
– Each individual activity you are proposing:
Football
Location – where this activity will take place:
Goals Sunderland
Dates / times:
Hazards2
List what could cause harm from this activity
e.g. falls from height, trip hazard, fire, etc.
Who exposed
List who might be harmed
from this activity
e.g. staff, contractors,
contributors, public, etc.
Risk3
For each hazard, decide
level of risk as if you were to
do the activity without your
controls
Control measures
For each hazard, list the measures you will be taking to minimise the risk identified
e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective
equipment, provision of first aid, etc.
Risk3
For each hazard,
decide level of risk
once all your controls
are in place
Contact with cold surface Staff, Contributors Possible / Negligible It might be very cold whilst shooting on set so the surrounding areas (doors, goals or on the
side of the pitch). When touching anything cold, I will make sure the actor is wearing gloves
to keep their hands warm and safe.
Unlikely/
Negligible
Slippery Surface Public, Staff,
Contributors
Possible / Slight The pitch that we are going to shoot on might be slippery and to make sure it is not, I will
check the pitch beforehand and see if it is safe to play on and work on for the staff too.
Unlikely / Slight
Object falling, flying or moving Staff, Contributors Possible / Moderate When shooting, there will be a ball to play football and this could hit a contributor or staff. To
reduce this risk, only the cameraman will be with the contributors and the ball will be on the
ground at all times.
Unlikely /
Moderate
Continue on separate sheet if necessary
1 – complete separate table for each activity 2 - from hazard list in Part A 3 - from risk matrix in Part A
Risk Assessment Form – Part B
Activity1
– Each individual activity you are proposing:
Running, Weight lighting,
Location – where this activity will take place:
Sunderland College - Gym
Dates / times:
Hazards2
List what could cause harm from this activity
e.g. falls from height, trip hazard, fire, etc.
Who exposed
List who might be harmed
from this activity
e.g. staff, contractors,
contributors, public, etc.
Risk3
For each hazard, decide
level of risk as if you were to
do the activity without your
controls
Control measures
For each hazard, list the measures you will be taking to minimise the risk identified
e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective
equipment, provision of first aid, etc.
Risk3
For each hazard,
decide level of risk
once all your controls
are in place
Trip hazard Public, Staff,
Contributors
Possible / Moderate At the gym, there may be trip hazards on the floor which may be a potential risk. To reduce
this risk, I will make sure the floor is tidied and where I am shooting, the area is clear for the
contributors, public and staff.
Unlikely / Slight
Fire Public, Staff,
Contributors
Possible, Severe As the gym is in a building, there could be a fire inside the gym or near the gym. If there is a
fire inside the gym, I will press the fire alarm immediately and get a member of staff whilst
getting everyone out.
Unlikely /
Moderate
Stress / Anxiety Contributors Unlikely, Negligible When the contributors are in the gym, they may get stressed because of the gym equipment
or what they need to do. I reduce this, I will listen to them at all times and will help them if
needed.
Remote /
Negligible
Continue on separate sheet if necessary
1 – complete separate table for each activity 2 - from hazard list in Part A 3 - from risk matrix in Part A

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Risk Assessment Template.doc

  • 1. Risk Assessment Form – Part A Production Name: Better Health Campaign TV Advert Organisation Sunderland College Production Address: Bede Campus, Durham Rd, Sunderland SR3 4AH Producer / Editor Tel: Mobile: Dylan Brown Details on file Details on file Start date 12/12/22 End date 14/12/22 Distribution Who gets a copy of the assessment N/A Outline of risk assessment Summary of what is proposed in terms of sequences and set ups. Single camera shoot (hand held and tripod). Shots will include different exercises either at the gym indoors or outdoors in a park or other exercising facilities. Team members / experts / contractors / contributors etc. List those involved S. Cotton, S. Marshall (actors) L. Braley (Cameraman) Locations Outline locations involved – indicate any which are hostile environments Sunderland College – Gym Barnes Park, Sunderland Goals Sunderland Assessor Name Signature Date completed Authoriser Name (if not Assessor) Signature Date authorised Hazard list – select your hazards from the list below and use these to complete Part B Situational hazards Tick Physical / chemical hazards Tick Health hazards Tick Assault by person Y Contact with cold liquid / vapour Disease causative agent Attack by animal Y Contact with cold surface Y Infection Y Breathing compressed gas Contact with hot liquid / vapour Allergic reaction Y Cold environment Y Contact with hot surface Lack of food / water Crush by load Y Electric shock Lack of oxygen Drowning Y Explosive blast Y Physical fatigue Y Entanglement in moving machinery Explosive release of stored pressure Repetitive action High atmospheric pressure Fire Y Static body posture Hot environment Hazardous substance Y Stress / anxiety Y Manual handling Ionizing radiation Venom poisoning Y Object falling, moving or flying Y Laser light Obstruction / exposed feature Lightning strike Y Environmental hazards Sharp object / material Y Noise Y Litter Y Shot by firearm Y Non-ionizing radiation Nuisance noise / vibration Y Slippery surface Y Stroboscopic light Physical damage Y Trap in moving machinery Vibration Y Waste substance released into air Trip hazard Y Waste substance released into soil / water Vehicle impact / collision Y Managerial / organisational hazards Falls from height Y Management factors (lack of communication, co-operation, co-ordination and competence) Y Risk matrix – use this to determine risk for each hazard i.e. ‘how bad and how likely’ Likelihood of Harm Severity of Harm Remote e.g. <1 in 1000 chance Very unlikely e.g. 1 in 200 chance Unlikely e.g. 1 in 50 chance Possible e.g. 1 in 10 chance Likely e.g. >1 in 3 chance Negligible e.g. small bruise Trivial Trivial Trivial Low Low Slight e.g. small cut, deep bruise Trivial Trivial Low Low Medium Moderate e.g. deep cut, torn muscle Trivial Low Medium Medium High Severe e.g. fracture, loss of consciousness Low Medium High High Extremely high Very Severe e.g. death, permanent disability Low Medium High Extremely high Extremely high
  • 2. Risk Assessment Form – Part B Activity1 – Each individual activity you are proposing: Running Location – where this activity will take place: Barnes Park, Sunderland Dates / times: Hazards2 List what could cause harm from this activity e.g. falls from height, trip hazard, fire, etc. Who exposed List who might be harmed from this activity e.g. staff, contractors, contributors, public, etc. Risk3 For each hazard, decide level of risk as if you were to do the activity without your controls Control measures For each hazard, list the measures you will be taking to minimise the risk identified e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective equipment, provision of first aid, etc. Risk3 For each hazard, decide level of risk once all your controls are in place Attack by animal Public, Staff, Contributors Unlikely / Severe I will make sure that the area is clear of animals and make sure no animal are near the area of shooting. If a animal comes near the shooting area, I will tell the owner (if they have one) to move it away. Very unlikely / Moderate Vehicle impact / collision Public, Staff, Contributors Unlikely / Severe I will not record near the road and make sure there are no vehicles around the shooting area. If there is a vehicle heading towards the shooting area, I will tell everyone to move out the way and everyone will be safe. Very Unlikely / Moderate Trip hazard Public, Staff, Contributors Possible / Moderate Before shooting the shot that I am going to take, I will make sure the path is cleared of any trip hazards so the actor that is in the shot, does not trip. For the surrounding areas too, I will make sure there are no other trip hazards for the public or contributors/staff. Unlikely / Slight Slippery surface Public, Staff, Contributors Possible / Moderate Before we shoot on the day, I will make sure the environment is dry and clear and will not cause any issues or health/injury problem when shooting. Unlikely/ Moderate Continue on separate sheet if necessary 1 – complete separate table for each activity 2 - from hazard list in Part A 3 - from risk matrix in Part A
  • 3. Risk Assessment Form – Part B Activity1 – Each individual activity you are proposing: Football Location – where this activity will take place: Goals Sunderland Dates / times: Hazards2 List what could cause harm from this activity e.g. falls from height, trip hazard, fire, etc. Who exposed List who might be harmed from this activity e.g. staff, contractors, contributors, public, etc. Risk3 For each hazard, decide level of risk as if you were to do the activity without your controls Control measures For each hazard, list the measures you will be taking to minimise the risk identified e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective equipment, provision of first aid, etc. Risk3 For each hazard, decide level of risk once all your controls are in place Contact with cold surface Staff, Contributors Possible / Negligible It might be very cold whilst shooting on set so the surrounding areas (doors, goals or on the side of the pitch). When touching anything cold, I will make sure the actor is wearing gloves to keep their hands warm and safe. Unlikely/ Negligible Slippery Surface Public, Staff, Contributors Possible / Slight The pitch that we are going to shoot on might be slippery and to make sure it is not, I will check the pitch beforehand and see if it is safe to play on and work on for the staff too. Unlikely / Slight Object falling, flying or moving Staff, Contributors Possible / Moderate When shooting, there will be a ball to play football and this could hit a contributor or staff. To reduce this risk, only the cameraman will be with the contributors and the ball will be on the ground at all times. Unlikely / Moderate Continue on separate sheet if necessary 1 – complete separate table for each activity 2 - from hazard list in Part A 3 - from risk matrix in Part A
  • 4. Risk Assessment Form – Part B Activity1 – Each individual activity you are proposing: Running, Weight lighting, Location – where this activity will take place: Sunderland College - Gym Dates / times: Hazards2 List what could cause harm from this activity e.g. falls from height, trip hazard, fire, etc. Who exposed List who might be harmed from this activity e.g. staff, contractors, contributors, public, etc. Risk3 For each hazard, decide level of risk as if you were to do the activity without your controls Control measures For each hazard, list the measures you will be taking to minimise the risk identified e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective equipment, provision of first aid, etc. Risk3 For each hazard, decide level of risk once all your controls are in place Trip hazard Public, Staff, Contributors Possible / Moderate At the gym, there may be trip hazards on the floor which may be a potential risk. To reduce this risk, I will make sure the floor is tidied and where I am shooting, the area is clear for the contributors, public and staff. Unlikely / Slight Fire Public, Staff, Contributors Possible, Severe As the gym is in a building, there could be a fire inside the gym or near the gym. If there is a fire inside the gym, I will press the fire alarm immediately and get a member of staff whilst getting everyone out. Unlikely / Moderate Stress / Anxiety Contributors Unlikely, Negligible When the contributors are in the gym, they may get stressed because of the gym equipment or what they need to do. I reduce this, I will listen to them at all times and will help them if needed. Remote / Negligible Continue on separate sheet if necessary 1 – complete separate table for each activity 2 - from hazard list in Part A 3 - from risk matrix in Part A