Fiction Adaptation Risk Assessment
Uploaded by
Stacey LeeFiction Adaptation Risk Assessment
Uploaded by
Stacey LeeRisk Assessment Form Part A
Division / Studio
Maidstone Studios
Department / Series
Business Unit / Production
Allington Community Centre,
Producer / Editor
Address
Castle Rd,
Tel:
Maidstone,
Mobile:
Hannah Darby
ME16 0PZ
Start date
01/12/14
Distribution
Crew, actors
End date
Who gets a copy of the assessment
Outline of risk assessment
Summary of what is proposed
Team members / experts / contractors /
contributors etc.
Crew, actors
List those involved
Locations
ACA
Outline locations involved indicate any which are
hostile environments
Assessor
Name
Date completed
Signature
Authoriser
Name
(if not Assessor)
Signature
Date authorised
03/12/14
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
Assault by person
Contact with cold liquid / vapour
Disease causative agent
Attack by animal
Contact with cold surface
Infection
Breathing compressed gas
Contact with hot liquid / vapour
Allergic reaction
Contact with hot surface
Lack of food / water
Crush by load
Electric shock
Lack of oxygen
Drowning
Explosive blast
Physical fatigue
Entanglement in moving machinery
Explosive release of stored pressure
Repetitive action
High atmospheric pressure
Fire
Static body posture
Hot environment
Hazardous substance
Manual handling
Ionizing radiation
Cold environment
Tick
Stress / anxiety
Venom poisoning
Object falling, moving or flying
Laser light
Obstruction / exposed feature
Lightning strike
Sharp object / material
Noise
Shot by firearm
Environmental hazards
Litter
Nuisance noise / vibration
Non-ionizing radiation
Slippery surface
Stroboscopic light
Physical damage
Trap in moving machinery
Vibration
Waste substance released into air
Trip hazard
Waste substance released into soil / water
Vehicle impact / collision
Managerial / organisational hazards
Falls from height
Management factors (lack of communication, co-operation, coordination and competence)
Risk matrix use this to determine risk for each hazard i.e. how
Likelihood of Harm
bad and how likely
Remote
Very unlikely
Unlikely
Possible
Likely
e.g. <1 in 1000 chance
e.g. 1 in 200 chance
e.g. 1 in 50 chance
e.g. 1 in 10 chance
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
Low
Medium
High
High
Extremely high
Severity of Harm
Severe e.g. fracture, loss of consciousness
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:
Hazards2
Who exposed
Location where this activity will take place:
Risk3
Control measures
Risk3
For each hazard,
decide level of risk
once all your controls
are in place
List what could cause harm from this activity
e.g. falls from height, trip hazard, fire, etc.
List who might be harmed
from this activity
e.g. staff, contractors,
contributors, public, etc.
For each hazard, decide level
of risk as if you were to do the
activity without your controls
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.
Filming in public area
Crew, actors, public
May get in the way of
shooting
Have signs around to let the public know that we are filming
Objects falling
Crew, actors
Equipment breaking
Make sure to bring extension lead, so that wires are flat on ground, also tape wires to the
floor.
Management Factors
Crew, actors
Lack of communication
Make sure crew are assigned roles and understand what to do. Also have a run through
with interviewee so that they know what they are doing.
Noise
Crew, actors, public
Cars/traffic on roads
Cold Environment
Crew, actors
Getting cold
Make sure crew and actors wrap up warm for the shoot
Stress/Anxiety
Crew
Getting stressed on shoot
Make sure to have shot list and script, so that we know what needs to be done on shoot
Continue on separate sheet if necessary
1 complete separate table for each activity
2 - from hazard list in Part A
Dates / times:
3 - from risk matrix in Part A
In general at all times take necessary precautions to avoid injury to oneself or others from these and other possible risks. Also
insure equipment is safe guarded at all times.
I have read and understood the safety rules above and have agreed to apply them at all times when involved in course activities.
Cast / crew signature:
Print Name:
Date:
Cast / crew signature:
Print Name:
Date:
Cast / crew signature:
Print Name:
Date:
Cast / crew signature:
Print Name:
Date:
Cast / crew signature:
Print Name:
Date:
Cast / crew signature:
Print Name:
Date:
Cast / crew signature:
Print Name:
Date:
