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Risk Assessment Form – Part A
Reference:

Sign-off status

Not Required

Blank Template

[planning/approved etc]

Assessme...
Risk Assessment Form – Part B
Reference:

6

Sign-off status

1

ACTIVITIES:
What are you doing, where, for how long and w...
Risk Assessment Form – Part B
Reference:

6

Sign-off status

2

ACTIVITIES:
What are you doing, where, for how long and w...
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Netherhall risk-assessment-form-4-2

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Netherhall risk-assessment-form-4-2

  1. 1. Risk Assessment Form – Part A Reference: Sign-off status Not Required Blank Template [planning/approved etc] Assessment summary details Assessment title * (Simple name for reference purposes) Recording opening scenes of a movie Division:* Netherhall School Department:* Media Studies Series/ Prod/Unit: Sticks and Stones Programme/Area: screenplay Responsible Manager: Contact office: Daniel Cooke Tel: 07902824609 Address: 6 Rosemary Greene Close Caxton Cambs , CB23 3PS Address/Tel: Date assessment created 22/11/13 Address/Tel: Confidential risk assessment? YES Assessment Outline (Summary of what is proposed) Assessment start date 26/11/13 Review / End date 2/11/13 Country location UK Hostile / travel advisory? Location details Owner: Malcolm Duffield NB: If the country location selected is ‘Hostile’ you are required to: complete the BBC Overseas High Risk Assessment Form Permissions written by Malcom duffield Crew / team (Roles, responsibilities, competencies) N/A Daniel Cooke- director/producer Adam Duffield, Ryan Hawkins, Charlotte Hall – Actors Lydia Sansom – Makeup artist Attachments (Detail supporting documents) Assessor(s) * Daniel Cooke Assessor safety competence (Person drafting risk assessment) Date signed-off * Authoriser(s) * (Person responsible for sign-off) Distribution (Who gets a copy of the assessment) Director and Producer , all crew Data Protection Act: Personal information collected for the purposes of risk assessment will be used to identify those at risk, and those involved in controlling risk, from this or similar activities and to fulfil the BBC's obligations under Health and Safety policy and legislation. It will be retained for up to 6 years after the expiry of the activity. It may be shared with other organisations, including our agents and contractors, with whom the risk or the control of risk is shared. Activity and Hazard Summary Activity [This is a summary of the activities listed in part B of the risk assessment.] Who Exposed Hazards{hazard titles Activity Risk Rating Comments log Who by Date / time received [* mandatory fields] Comments Assessor response Date/ time responded
  2. 2. Risk Assessment Form – Part B Reference: 6 Sign-off status 1 ACTIVITIES: What are you doing, where, for how long and who will be involved? Complete the fields in the form below). Blank Template [planning/approved etc] HAZARDS & CONTROLS: How could someone become hurt or made ill and how are you going to prevent this from happening? Activity Title:* Riding a moped Activity Description: Riding a moped onto set multiple times with one person in the beginning then leaving set with three people on the back. List those managing this Activity and their competence: Daniel Cooke- CBT trained and owner of the moped Who & how many are at risk from this Activity? 3 Actors Hazards How could someone become hurt or made ill Control measures How are you going to prevent this from happening? Crashing the moped while in or out of motion Efficient training to the rider of the moped and making sure that they are capable to ride it before allowing them to attempt it. Burning Yourself on the Exhaust/engine of the moped Making sure that all actors and crew are aware of the heat that is produced and the risk of burn. Risk Level*: After your controls have been applied what is your assessment of the risk level of this activity? Add additional activities as required – by copying this section and pasting below [* mandatory fields] Medium
  3. 3. Risk Assessment Form – Part B Reference: 6 Sign-off status 2 ACTIVITIES: What are you doing, where, for how long and who will be involved? Complete the fields in the form below). Activity Title:* [planning/approved etc] HAZARDS & CONTROLS: How could someone become hurt or made ill and how are you going to prevent this from happening? Firing a gun Activity Description: Firing a bb gun /air pistol off camera. List those managing this Activity and their competence: Daniel Cooke – Owner of Pistol Adam Duffield – Owner of Air Pistol Who & how many are at risk from this Activity? All Crew and Actors ( 3 Actors and 2 crew) Hazards How could someone become hurt or made ill Control measures How are you going to prevent this from happening? Accidental firing of hand gun (BB). Make sure that the guns are not unnecessarily loaded with ammo. Risk Level*: After your controls have been applied what is your assessment of the risk level of this activity? Add additional activities as required – by copying this section and pasting below [* mandatory fields] Blank Template Low

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