VOLUNTEER RISK ASSESSMENT FORM

Part A

DEPARTMENT/ SERVICE
Assessor/ Person(s) assisting with the assessment	DATE
TASK / ACTIVITY (Include duration and frequency of task/ activity)
Likelihood of Occurrence Severity of Outcome 1 Negligible 2 Slight 3 Moderate 4 Severe 5 Very Severe 1 Very Unlikely LOW (1) LOW (2) LOW (3) LOW (4) LOW (5) 2 Unlikely LOW (2) LOW (4) LOW (6) MEDIUM (8) MEDIUM (10) 3 Possible LOW (3) LOW (6) MEDIUM (9) HIGH (12) HIGH (15) 4 Probable LOW (4) MEDIUM (8) HIGH (12) HIGH (16) HIGH (20) 5 Very Likely LOW (5) MEDIUM (10) HIGH (15) HIGH (20) HIGH (25)	Persons / groups at risk
A	Employees	D	General Public / Pupils
B	Volunteers	E	Visitors
C	Clients / Service users	F	Young person / Work experience
Residual risk rating This is a simple calculation to determine the residual rating of a particular hazard. It is based on the likelihood of an injury, ill health, property damage or loss occurring from a hazard and the seriousness of the outcome. Higher the risk rating number, higher the risk. Likelihood of occurrence X Severity of outcome = Risk Rating Example: Likelihood (possible 3) X Severity (Moderate 3) = Risk Rating (Medium 9)

Part B

What are the hazards and What could happen	Affected persons groups	What are the existing control measures	Further action required to eliminate or reduce the risk (who by and Date)	Residual risk rating (refer to chart)

Part C

Links to other risk assessments and or safe working instructions - please state
Name and Sign When the assessment is complete it should be signed to say that is the case and all identified actions have been implemented	Date
Review - Before work starts, it is important to consider the content on this risk assessment to ensure it still valid. For example, are there any significant changes, additions or omissions at the site not identified on the assessment? Are there any additional hazards or risks? Please record any changes required and or action taken, then date and sign
Reviewer Name & Date	Notes
Reviewer Name & Date	Notes