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Health and Safety Risk Assessment Template

A health and safety risk assessment template is a standardized document used to identify potential hazards and assess the associated risks in a given work environment. The template typically includes sections for documenting hazards, assessing the likelihood and severity of risks, and outlining measures for risk control and mitigation.

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Are PPE requirements sufficient? -Should gloves be required? -Should a face shield be required?
Is PPE supplied adequate for the task? -Previous injuries when using current PPE? Why? -PPE being replaced excessively? (e.g. Burn holes, soaked with liquid chemicals, etc.)
Is PPE being worn properly? -Ear plugs completely inserted into ears -Safety glasses fit properly and pass fit test (gaps no larger than width of finger) -Gloves being worn when handling materials that are sharp, hot, etc.
PPE supplies readily available to operators (Interview >= 2 employees.)
Are all tools in good working condition? -Held together with tape? -Excessive noise/vibration? -Requires excessive manual manipulation?
All existing guarding in place? -Guards laying on the floor? -Bolts/Screws missing from fixed guarding? -Guards shifted causing open point of operation?
Existing guarding sufficient in preventing access to the point of operation? -Gaps in guarding too large? -Use of chains as barrier guarding? -Interlocked/Presence sensing devices not working properly? -No guard installed where it should exist?
Machinery working properly and not causing regular manual manipulation? -Frequent breakdowns causing manual work? -Machinery producing excessive noise/vibration due to disrepair?
Machinery design/layout inherently hazardous? -Congestion created in design? -Equipment no longer safest design for the process? -Can a hazardous piece of equipment be eliminated from the process/work area?
Hazard Communication
Employees know how to find MSDS and understand the hazards of the chemicals they work with. (Interview >=2 employees)
Ventilation adequate for the airborne health hazards? -Industrial hygiene sampling results on file? -Employee complaints about "fumes" or "nausea/dizziness"
Chemicals are stored in proper containers and labeled properly? -Secondary containers that are not in control of current shift labeled with HMIS label or equivalent? -Labels legible and accurately indicates the chemical that is inside the container?
Incidental spills cleaned up immediately? -No evidence of spills being left? -Chemicals being tracked on employees' shoes and/or mobile equipment?
Chemicals stored properly? -Flammable materials not in use stored in proper cabinet/safety container? -Incompatible materials stored away from each other?
Walking/Working Surfaces and Fall Protection
Proper labels in place and legible? -Portable ladders and stairways require labeling indicating weight limits.
Floors and work platforms free of excessive debris and clutter? -Excessive oil, trash, manufacturing byproducts, etc. in the work are? -No items stored on stairs?
Handrails secure and free of excessive defects? -Heavily damaged handrails that require replacement? Loose? Broken welds? Bent handrails and/or toe boards? -Handrails do not contain excessive oil/grease?
Handrails installed where a fall from a height of four feet or greater exists?
Fall protection equipment available for working at heights greater than 4 feet from the working surface below it where fall prevention is not available?
Harnesses, lanyards, SRL, and lifelines maintained in good condition and inspected properly? -Inspection labels present and legible? -Webbing free of frayed, cut or broken fibers? -Quick connect buckles working properly?
Emergency Response/Fire Protection
Fire extinguishers inspected monthly and unblocked?
Employees aware of emergency procedures and where assembly areas are? (Interview >=2 employees)
Eyewash/Safety Shower stations inspected and unblocked?
Spill kits are available where needed and are equipped/inspected as required?
Sufficient emergency equipment installed in the area? -Fire extinguishers, eyewash, safety shower, spill kits, alarm pull stations, etc.
Fire suppression systems not blocked/damaged?
Mobile Equipment
Equipment inspected per inspection frequency requirements?
Operators using horns and warning devices where required?
No passengers on equipment designed for operators only?
Electrical Hazards/Arc Flash
High voltage signs in place and visible?
Debris/Tools stored on top of electrical cabinets?
Electrical cabinets closed and in good repair? -Do the cabinets close securely? -Knock-outs all in place? -Large dents in the housing/door?
Electrical cabinets not blocked? -Nothing within 36 inches of the front of the cabinet? -Clear access/pathway to electrical cabinets?
Arc flash signage in place? -Indicates arc flash category?
Proper arc flash PPE available and in use?
Hazardous Energy Control (Lockout/Tagout)
Employees expected to conduct lockout trained and equipped properly? -Employees understand their role and requirements? -Employees have locks available if needed?
Employees locked out during a change over and/or other tasks that require lockout? -All employees who are working on the equipment have their own lock affixed to the proper energy source(s)? -Lockout was verified, stored energy was dissipated and equipment will not operate?
Energy control procedures exist for all equipment in the area and employees know where to find them?
Lockout exceptions have been adequately evaluated and determined safe? -Do regular tool/machine adjustments introduce hazards with unacceptable risk? -Other exceptions?
Crane/Hoist Safety
Inspections completed as per requirements? -Operator inspections completed? -PM's completed as per the schedule?
Are employees working under suspended loads?
Are cranes working within their operating limits? -Capacity not exceeded? -Upper limit switch not used as a stop?
General Safety and Housekeeping
Trash, debris, and equipment not left laying around?
Equipment free of excessive dust, oil and/or soot?
Floor surfaces covered in oil/dust covering the painted surface?
General tripping hazards due to housekeeping, equipment layout, and/or workstation design?
Signature and Finalization
I have completed this assessment to the best of my knowledge. This audit is not intended to identify all safety and health hazards, but to identify all visible/known hazards as of the date printed on the completed assessment. assessment.
Select date
General Comments
Overall Safety Score
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The Importance of a Health and Safety Risk Assessment Template

In any work environment, it’s essential to prioritize the health and safety of employees. A health and safety risk assessment template is a tool that helps identify potential hazards and assess the associated risks. It is an essential part of any risk management strategy.

The template typically includes sections for documenting hazards, assessing the likelihood and severity of risks, and outlining measures for risk control and mitigation. It is a standardized document that can be used across different work environments to ensure consistent safety practices.

Using a health and safety risk assessment template can help identify potential hazards that may have been overlooked otherwise. It provides a structured approach to identifying and assessing risks and helps ensure that appropriate measures are taken to mitigate or control them.

Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.
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