Risk Assessment Checklist
Facility Management
Safety
Workplace Risk Assessment
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Audit

(1). Crushing - Can anyone be crushed due to:

Material falling from plant?
Safe
At Risk
N/A
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Lack of capacity for the plant to be slowed, stopped or immobilised?
Safe
At Risk
N/A
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The plant tipping or rolling over?
Safe
At Risk
N/A
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Uncontrolled or unexpected movement of the plant or its load?
Safe
At Risk
N/A
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Parts of the plant collapsing?
Safe
At Risk
N/A
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Coming in contact with moving parts of the plant during testing, inspection, use, maintenance, cleaning or repair?
Safe
At Risk
N/A
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Being thrown off or under the plant?
Safe
At Risk
N/A
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Being trapped between the plant and materials or fixed structures?
Safe
At Risk
N/A
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Other factors?
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Other factors?
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1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE
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(2). Entanglement

Body parts, clothing, equipment or other materials being in contact with moving parts of the plant?
Safe
At Risk
N/A
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Other factors?
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Other factors?
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1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE
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(3). Cutting, Stabbing and Puncturing

Coming in contact with sharp or flying objects?
Safe
At Risk
N/A
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Coming in contact with moving parts of the plant during testing, inspection, operation, maintenance, cleaning or repair of the plant?
Safe
At Risk
N/A
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Parts of plant disintegrating?
Safe
At Risk
N/A
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The mobility of the plant?
Safe
At Risk
N/A
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Uncontrolled or unexpected movement of the plant?
Safe
At Risk
N/A
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Other factors?
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Other factors?
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1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE
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(4). Shearing / Burning / Friction

Burnt, gain abrasions, etc?
Safe
At Risk
N/A
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Sheared in operation of plant?
Safe
At Risk
N/A
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Other factors?
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Other factors?
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1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE
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(5). Striking

Uncontrolled or unexpected movement of the plant or material handled by the plant?
Safe
At Risk
N/A
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Plant, parts of the plant or work pieces disintegrating?
Safe
At Risk
N/A
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Work pieces being ejected?
Safe
At Risk
N/A
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Mobility of the plant?
Safe
At Risk
N/A
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Other factors?
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Other factors?
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1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE
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(6). High Pressure Fluid /Gases

Fluids/Gases under high pressure in normal use?
Safe
At Risk
N/A
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In the instance of plant failure?
Safe
At Risk
N/A
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Other factors?
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Other factors?
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1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE
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(7). Electrical

The plant contacting live electrical conductors?
Safe
At Risk
N/A
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Electrical Leads on the ground
Safe
At Risk
N/A
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Plant working close to electrical conductors?
Safe
At Risk
N/A
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Overload of electrical circuits?
Yes
No
N/A
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Damaged or poorly maintenance electrical components &/or cables?
Safe
At Risk
N/A
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Water near electrical equipment?
Safe
At Risk
N/A
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Lack of isolation procedures?
Safe
At Risk
N/A
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Other factors?
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Other factors?
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1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE
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(8). Gases or Vapors

Gases, vapours, liquids, dusts or other hazardous substances by the operation of the plant?
Yes
No
N/A
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Other factors?
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Other factors?
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(9). Slips, Trips or Falls

Uneven or slippery work surfaces?
Yes
No
N/A
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Poor housekeeping, such as shavings in the vicinity of the plant, spillage not cleaned up?
Yes
No
N/A
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Obstacles being placed in the vicinity of the plant?
Yes
No
N/A
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Other factors?
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Other factors?
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(10). Manual Handling

Does use of the plant or equipment involve repetitive or sustained postures?
Yes
No
N/A
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Does use of the plant or equipment involve high force actions?
Yes
No
N/A
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Does use of the plant or equipment involve an jerking actions?
Yes
No
N/A
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Has there been a report of musculoskeletal disorder associated with the task?
Yes
No
N/A
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Does this task require employees to be working with their hands above their shoulder?
Yes
No
N/A
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Other factors?
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Other factors?
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(11). Suffocation

lack of oxygen
Yes
No
N/A
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Atmospheric contamination?
Yes
No
N/A
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Other factors?
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Other factors?
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(12). Temperature

Coming into contact with objects at high temperature?
Yes
No
N/A
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Coming into contact with objects at Low temperature?
Yes
No
N/A
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Other factors?
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Other factors?
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Completed by date/time
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Responsibility
Search and select all that apply
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Issue identified. Comment on progress/update for actions
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Risk Control Action Plan Risk 2

Completed by date/time
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Responsibility
Search and select all that apply
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Issue identified. Comment on progress/update for actions
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Risk Control Action Plan Risk 3

Completed by date/time
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Responsibility
Search and select all that apply
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Issue identified. Comment on progress/update for actions
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Risk Control Action Plan Risk 4

Completed by date/time
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Responsibility
Search and select all that apply
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Issue identified. Comment on progress/update for actions
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Risk Control Action Plan Risk 5

Completed by date/time
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Responsibility
Search and select all that apply
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Issue identified. Comment on progress/update for actions
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Risk Control Action Plan Risk 6

Completed by date/time
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Responsibility
Search and select all that apply
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Issue identified. Comment on progress/update for actions
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Risk Control Action Plan Risk 7

Completed by date/time
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Responsibility
Search and select all that apply
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Issue identified. Comment on progress/update for actions
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Risk Control Action Plan Risk 8

Completed by date/time
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Responsibility
Search and select all that apply
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Issue identified. Comment on progress/update for actions
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Risk Control Action Plan Risk 9

Completed by date/time
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Responsibility
Search and select all that apply
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Issue identified. Comment on progress/update for actions
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Risk Control Action Plan Risk 10

Completed by date/time
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Responsibility
Search and select all that apply
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Issue identified. Comment on progress/update for actions
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Signature

Auditor to sign here
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