Risk Assessment Form

Department: Service: Reference:

Activity: Office work Site: Various

People at Risk: Staff and visitors. Additional Information:

Corporate Health & Safety Policy Manual (including Display Screen
Equipment and Young People at Work, Risk Assessments (including
Pregnant Workers assessment and Student/Apprenticeship Work
placement assessment), Manual Handling Assessments, Low-Risk
Workplace Inspection Checklist, Fire Log Book. Separate risk
assessment may be needed for lone working and stress. Stepladder
inspection checklist.

Name of Person Completing Form: Job Title Date Review Date:…………..…

Risk Evaluation
Hazard Risk Initial Existing Control Measures Final Additional Action
Rating Rating Required (action by
(L, M, H,) (L, M, H,) whom and completion
date)
Slips and Trips Sprains, fractures M Defects reported immediately. L
Adequate lighting provided.
No trailing cables or leads.
Work areas and walkways kept clear. Filing
cabinet draws and doors kept closed when
not in use.
Good housekeeping.
Floors cleaned on a regular basis. Spillages
cleaned up immediately.
Floor surfaces maintained to good standard,
defects reported to the Manager.

Owners: Northumberland County Council Page 1 of 5 Author: add your name here
Issue: 2.0 Date: Oct 2013
 Risk Assessment Form
Hazard Risk Initial Existing Control Measures Final Additional Action
Rating Rating Required (action by
(L, M, H,) (L, M, H,) whom and completion
date)
Electrical Appliances Electric shock, injury. M All electrical equipment has a portable L
Fire. appliance test (PAT).
Liquid spills mopped up immediately.
Any defects reported immediately, defective
equipment taken out of use and promptly
replaced.
Sockets not overloaded.

Fire Smoke inhalation, M Fire drills carried out regularly. L

burns or fatality. Fire drill procedures included in all staff
inductions.
Trained Fire Wardens in place.
All fire exits kept clear.
Fire alarm points, emergency lighting and
fire extinguishers tested and maintained.
Any heaters in use switched off at the end of
the working day.
Combustible materials kept away from
heaters and disposed of daily.
Waste bins emptied on a regular basis.
Fire risk assessment completed for
premises (see Fire Log Book)
Display Screen Back pain, headaches, M Adjustable blinds to avoid glare. L
Equipment eyesight deterioration. Regular breaks taken.
DSE workstation assessments carried out
and reviewed as appropriate.
Lighting and temperature suitably controlled.
Eye tests provided for those who need them
(paid for by employer).

Owners: Northumberland County Council Page 2 of 5 Author: add your name here
Issue: 2.0 Date: Oct 2013
 Risk Assessment Form
Hazard Risk Initial Existing Control Measures Final Additional Action
Rating Rating Required (action by
(L, M, H,) (L, M, H,) whom and completion
date)
Laptops used with docking station, screen,
keyboard and mouse.
Manual Handling Back injuries, cuts and M Trolley available where required. L
abrasions High shelves used for storing light and
infrequently used items.
Heavy items stored at low level.
Separate manual handling assessment
undertaken as required. Training in manual
handling carried out, where necessary..
Poor storage Injury from dislodged M High shelves used for storing light and L
items or collapse of infrequently used items. Heavy items to be
shelves stored at low level.
Access equipment available, for example,
hop-up step, step ladders for higher
shelves.
Use of Step Ladders Falls/fractures/ M Only industrial class ladders used. L
bruising Loads not carried whilst climbing the
stepladder. Where carried loads should be
placed at an intermediate height or passed
up by an assistant.
Only one person ascends the stepladder at
any one time.
Over-reach from the stepladder is avoided.
Ladders always used on stable flat floor
whilst ensuring floor area around base of
stepladder is kept clear
Stepladder to be inspected prior to use. Any
defects to be reported & damaged
equipment taken immediately out of use.

Owners: Northumberland County Council Page 3 of 5 Author: add your name here
Issue: 2.0 Date: Oct 2013
 Risk Assessment Form
Hazard Risk Initial Existing Control Measures Final Additional Action
Rating Rating Required (action by
(L, M, H,) (L, M, H,) whom and completion
date)
Poor standards of General L Premises cleaned on a regular basis L
hygiene and welfare discomfort/illness Staff maintain high standard of hygiene.
Building maintained and all defects reported
to the manager.
Toilets supplied with hot and cold water,
soap and hand drying facility.
Staff room/kitchen facilities provided.
Any inappropriate Harm to unborn child/ M Expectant mother risk assessment to be L
activity carried out by expectant mother. completed following notification to
an expectant mother. Supervisor/Manager.
Inexperienced young Harm to self and M Student work placement/Apprenticeship risk L
person undertaking others. assessment to be completed.
work placement/
apprenticeship.

Owners: Northumberland County Council Page 4 of 5 Author: add your name here
Issue: 2.0 Date: Oct 2013
Risk Assessment Form