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Risk Assessment Form - Part A

This risk assessment form evaluates the risks associated with a short film scene where a woman, Jasmin, runs down the street and falls after being followed. The scene will take place on a public street, posing risks of interference from members of the public. Hazards identified include falling, which could cause injury, and running into strangers during filming. Control measures like padded gloves and clearing the area are proposed to minimize risks and lower the likelihood of harm. The assessment rates the risks as unlikely with negligible to slight potential harm after controls are implemented.

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Emily Jones
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155 views2 pages

Risk Assessment Form - Part A

This risk assessment form evaluates the risks associated with a short film scene where a woman, Jasmin, runs down the street and falls after being followed. The scene will take place on a public street, posing risks of interference from members of the public. Hazards identified include falling, which could cause injury, and running into strangers during filming. Control measures like padded gloves and clearing the area are proposed to minimize risks and lower the likelihood of harm. The assessment rates the risks as unlikely with negligible to slight potential harm after controls are implemented.

Uploaded by

Emily Jones
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Risk Assessment Form Part A

Production Name: MordVale Organisation N/A


Production Address: Green Lane Producer / Editor Emily Jones
Kettering Tel: 01536 ******
Northamptonshire Mobile: 07889 ******
Start date 11/12/16 End date 11/12/16

Outline of risk assessment Jasmin runs walks down the street, and begins to run noticing she is being followed. She runs around a
corner and falls to the floor (she either trips or is pushed) where she will struggle slightly to look like she is
Summary of what is proposed in
being held down, before she is killed. (this last bit is not shown)
terms of sequences and set ups.
Team members / experts / Myself cameraman, director, the mysterious hand which pushes her down.
contractors / contributors etc. Jasmin the actress
List those involved

Locations Its on a public street which could mean a risk in members of the public getting in the way whilst she runs.
Outline locations involved indicate
any which are hostile environments

Assessor Name Jasmin Hills Date completed 10/12/16


Signature
Authoriser Name Emily Jones Date authorised 10/12/16
(if not Assessor) Signature

Risk matrix use this to determine risk for


each hazard i.e. how bad and how likely Likelihood of Harm
Remote Very unlikely Unlikely Possible Likely
Severity of Harm e.g. <1 in 1000 chance e.g. 1 in 200 chance e.g. 1 in 50 chance e.g. 1 in 10 e.g. >1 in 3 chance
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
Severe e.g. fracture, loss of consciousness Low Medium High High Extremely high
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: Location where this activity will take place: Dates / times:
As above As above As above

Hazards2 Who exposed Risk Control measures Risk


List what could cause harm from this activity List who might be harmed For each hazard, decide For each hazard, list the measures you will be taking to minimise the risk identified For each hazard,
e.g. falls from height, trip hazard, fire, etc. from this activity level of risk as if you were e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective decide level of risk
e.g. staff, contractors, to do the activity without equipment, provision of first aid, etc. once all your controls
contributors, public, etc. your controls are in place

We will try to control the falling, by making sure there is nothing sharp on the ground and that Unlikely risk of
Falling |Jasmin she is falling in a manner where she can comfortable land without breaking anything, such as slight harm.
She may hurt herself bones or skin.
POST NOTE: she scraped her hands whilst falling the first time, which was treated, and she
then wore padded gloves for extra protection.
Jasmin, public They could collide and We will make sure that the surrounding area is clear before shooting anything. Unlikely risk of
Running into a stranger could both possible be negligible harm.
injured

Continue on separate sheet if necessary


1 complete separate table for each activity 2 - from hazard list in Part A 3 - from risk matrix in Part A

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