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High Hopes Services Pty Ltd
ABN: 61 642490873
www.highhopesservices.com.au
Risk Assessment
Risk Assessment Scope
Participant Name:
Assessment location:
Assessment date:
Persons Involved in Risk Assessment (Team)
Signature
Describe the activity/task/item/product:
Risk assessment is the combined effort of: identifying and analysing potential events that may negatively impact individuals, assets, and/or
the environment; and making judgments "on the tolerability of the risk on the basis of a risk analysis" while considering influencing factors
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High Hopes Services Pty Ltd
ABN: 61 642490873
www.highhopesservices.com.au
Risk Assessment Matrix
(Use this table to determine the risk ratings)
Page 3 of 6
High Hopes Services Pty Ltd
ABN: 61 642490873
www.highhopesservices.com.au
Hazard Identification and Risk Assessment
Haz
no.
YES / NO or
comment
Recommended Actions
(e.g. place wet floor hazard signage)
Residual
risk rating
(e.g. 3C)
1
2
3
4
5
6
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High Hopes Services Pty Ltd
ABN: 61 642490873
www.highhopesservices.com.au
7
8
9
10
11
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High Hopes Services Pty Ltd
ABN: 61 642490873
www.highhopesservices.com.au
This Risk Assessment will need to be changed or updated in case of any change in the participant’s circumstances or the service provided
by High Hopes Services
A copy of the document will be submitted to the participant and included in the participant’s file.
Does the participant give the authorization to submit this to the Support Coordinator?
YES NO
Page 6 of 6
High Hopes Services Pty Ltd
ABN: 61 642490873
www.highhopesservices.com.au
Review
Control measures have been reviewed and no further risks have been identified
Yes No
If Yes, specify: ______________________________________________________________
Are further reviews
required? No Yes
When:
Reviewer name:
Reviewer signature:
Date:
Record of subsequent reviews.
Review date:
Reviewed by:
Description of any
changes: