Take Five 1. Stop 2. Think 3. Look for Hazards 4. Plan 5.

Proceed
WORK DETAIL To be completed for all work Title
WMH Facility: Unit: Work Description Work Centre Work Order No.

No. of Workers: Works Lead Name Supervisor Name:

Signature: Date: Signature: Date:

1. STOP 2. Think through the task Yes No

See your Supervisor

Am I clear on what the task is ☐ ☐
Do I have the necessary work permits and/or authorities to do the task ☐ ☐
Is there a JHA/SWMS/SOP/Work Instruction for this task ☐ ☐
Do I have the required skills, training and licenses for the task ☐ ☐
Are my tools/equipment appropriate for the task and in good working order ☐ ☐
Do I have the correct personal protective equipment for the task ☐ ☐

3.1 Look for Hazards Yes No

1) Gravitational Slips, trips, falls at the same Fall from Heights Access/work beneath Falling objects ☐ ☐
level suspended load
2) Kinetic /Mechanical Caught in/between moving Struck by moving Contact with sharp objects Struck by projectiles. ☐ ☐
plant or parts; vehicles/mobile
plant
3) Noise and Vibration Excessive noise Vibrating Contact with vibrating tools/objects ☐ ☐
plant/vehicles
4) Electrical Exposed or faulty wiring or Contact with live Exposure to high fault Mechanical damage to ☐ ☐
equipment; static shocks electrical parts; currents power leads, fixed
electrical arcing electrical wiring;
5) Chemical Ingestion, absorption or Uncontrolled spill Burns / splash in eyes Specific exposure: ☐ ☐
inhalation of chemicals Asbestos /Lead
6) Thermal and Work Lighting workplace and Uneven/unstable Weather and atmospheric Contact with hot/cold ☐ ☐
Environment equipment/tool design; ground or work conditions; Remote and objects / surfaces/ liquids
Restricted working space surface isolated work
7) Biological Exposure to algal, bacterial, Animal, insect and Sharps injury/needle-stick Specific exposure: Contact ☐ ☐
fungal, viral or parasitic spider bites/stings exposure with raw sewage
agents
8) Fire / Explosions Condition leading to fire/explosion Ignition of gas/dust in a hazardous area ☐ ☐
9) Manual Tasks Repetitive or sustained Repetitive Exposure to vibration; Handling unstable or ☐ ☐
force; High or sudden movement; Tool use which requires awkward objects /loads;
force; Handling heavy loads Sustained or excessive force;
awkward posture;
10) Pressurized energy Release of a stored energy i.e. gases, water, oil Release of spring/tension ☐ ☐
subject to high/ low pressures energy
11) Psycho-social and Exposure to workplace Exposure to Working for excessive Working under the ☐ ☐
medical bullying, harassment, traumatic time periods and/or while influence of alcohol/drugs
violence & aggression incidents; fatigued
12) Radiation Non iodizing radiation: Ultraviolet light (artificial/sunlight), laser, infra-red, microwave, radio frequency, ☐ ☐
welding arc light
3.2 Assess the Hazards Refer to the Risk Management Guide
What is the risk level Extreme High Moderate Low
STOP! - SEE YOUR SUPERVISOR AND/OR COMPLETE/UPDATE JHA/SWMS Risk Level = E /H /M ☐ L☐

4. Plan the work - Make the Hazards Safe (refer to the Hierarchy of Control)
Haz No. Controls are established to manage the hazard(s) e.g. Barricades erected / warning signs / specialised PPE Yes No
☐ ☐

☐ ☐

☐ ☐

☐ ☐

☐ ☐

☐ ☐

5. PROCEED TO COMPLETE THE TASK SAFELY Are all hazards removed or minimised to a low risk level ☐ ☐

STOP - DO NOT START THE TASK! - DISCUSS WITH YOUR SUPERVISOR BEFORE PROCEEDING ☐

Infrastructure and Assets-WHS-Take Five Risk Assessment-Rev 6.1

4. Plan the work - Make the Hazards Safe (refer to the Hierarchy of Control)
Haz No. Controls are established to manage the hazard Eg Barricades erected / warning signs / specialised PPE Yes No
☐ ☐

☐ ☐

☐ ☐

☐ ☐

☐ ☐

☐ ☐

☐ ☐

☐ ☐

5. PROCEED TO COMPLETE THE TASK SAFELY Are all hazards removed or minimised to a low risk level ☐ ☐

STOP - DO NOT START THE TASK! - DISCUSS WITH YOUR SUPERVISOR BEFORE PROCEEDING ☐
WORKER DECLARATION
I have been given the opportunity to comment on the context of this Take 5. I have read, understood and agree with how to safely carry out the
activities listed above.
Names of workers consulted Signature of workers Date

COMPLETION
☐ Has the work area been left tidy and safe ☐ Are changes to equipment documented and communicated
☐ Are site personnel aware of status of work including remaining
☐ Are all incidents, near miss incidents, unsafe situations reported
isolations
Risk Management Guidance
Definition Hazard Category Risk control means taking action to eliminate health and safety
“A hazard is a situation or thing that risks so far as is reasonably practicable, and if that is not possible,
has the potential to harm a person”. minimising the risks so far as is reasonably practicable.
Hazards at work may include noisy 1. Gravitational
2. Kinetic /Mechanical The Table below illustrates the hierarchy of controls.
machinery, a moving forklift, use and
3. Noise and Vibration
storage of chemicals, electricity, Hierarchy of Control
4. Electrical
working at heights, a repetitive job, Hierarchy of Control
5. Chemical
bullying and violence at the 6. Thermal and Work Highest Most
workplace. Environment Eliminate the hazards (i.e. removing the risk
completely).
Risk is the possibility that harm 7. Biological

Level of Health and Safety Protection

8. Fire / Explosions

Reliability of Control Measures

(death, injury or illness) might occur Substitute the hazard with something safer (e.g.
when exposed to a hazard. 9. Manual Tasks replacing a hazardous chemical with a non-
hazardous chemical to complete the same task).
10. Pressurized energy Isolate the hazard from people (e.g. physical
guarding).
Expressed as a risk Statement
11. Psycho-social and Reduce the risk through engineering controls (e.g.
ventilation system, trench shoring etc.).
medical
“The risk of <harm> due to <exposure
12. Radiation
to hazard> resulting in Reduce exposure to the hazard using administrative
actions (e.g. training, site induction, competency
<consequence>”. assessment, work instructions, job rotation etc.).
Use Personal Protective Equipment (PPE) (e.g.
respirator, hearing protection etc.).

Lowest Least

What is the LIKELIHOOD of an event occurring

Descriptor Definition Frequency Probability
Rare No identified or known events occurring. Only occurs Event expected to occur less than once every five years. Less than 5 percent
in exceptional circumstances.
Unlikely Evidence of event occurring in the past, but unlikely Event expected to occur once in the next five years. 5-30 percent
to occur in the future.
Possible There is evidence of several events in the past. It Event expected to occur once in the next two years. 30-60 percent
would not be a surprise if it occurred.
Likely Event occurs from time to time. Event expected to occur once in the next year. 60 - 90 percent
Almost Certain Risk event is expected to occur. Event expected to occur within the next three months. More than 90 percent

What would be the CONSEQUENCES should an event occur

Negligible/ Minor Moderate Major Extreme / Catastrophic
Insignificant
No injury/illness/time lost. No lost time injury. An injury involving a temporary loss of function An event resulting An event resulting in loss of life.
Minor adjustment to An injury requiring or a notifiable event (illness/injury requiring in permanent loss of
operational routine. first aid or medical overnight inpatient hospitalisation, or a function or
treatment. dangerous event requiring notification). disability.

Indicate the LIKELIHOOD and CONSEQUENCE in the table below to establish the RISK RATING
LIKELIHOOD CONSEQUENCES
Negligible/ Insignificant Minor Moderate Major Extreme

Rare Low Low Medium Medium High

Unlikely Low Low Medium High High
Possible Low Medium High High Extreme
Likely Medium Medium High Extreme Extreme
Almost Certain Medium Medium High Extreme Extreme

Risk Rating Minimum Action Required (specific to safety risks)

LOW Monitor to ensure no change to risk level occurs.
MEDIUM Action required within one month.
HIGH  Detailed risk assessment required.
 Action required within one to two weeks (short and/or long-term controls).
 Report in accordance with West Moreton Health (WMH) risk requirements
 Report within one week to the local Work Safety and Wellbeing (WSW) Unit.
 Long term control plan including detailed risk assessment required with management involvement/review.
EXTREME  Immediate action required (short and/or long-term controls).
 Work activity/component may be ceased/restricted until short term controls implemented to reduce risk level.
 Report in accordance with WMH risk requirements. Report immediately to the local WSW Unit.
 Long term control plan including detailed risk assessment required with senior management involvement/review.