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Risk Assessment Form –
Part A
Production Name: Sunderland Culture – Content
Creation Documentary
Organisation Sunderland College Creative Media
Production Address: Durham Road,
Sunderland,
SR3 4AH
Sunderland Bowl
141 High St W, Sunderland
England
SR1 1TR
Producer / Editor
Tel:
Mobile:
Elliot Daroczy
07398616881
07398616881
Start date 07/01/23 End date 23/02/23
Distribution
Who gets a copy of the assessment
Neil Wilson, Emma Leslie-Boddy
Outline of risk assessment
Summary of what is proposed in
terms of sequences and set ups.
My camera and tripod will be taken outside to Sunderland Bowl for proposed shots:
Me Playing in the arcade
Me Recording the Machines
Team members / experts /
contractors / contributors etc.
List those involved
Elliot Daroczy
Locations
Outline locations involved – indicate
any which are hostile environments
Sunderland College – Media Classroom (VPA 126)
My House – Sunderland
Sunderland City Centre
Assessor Name
Signature
Date completed 22/11/22
Authoriser Name
(if not Assessor) Signature
Date authorised 22/11/22
Hazard list – select your hazards from the list below and use these to complete Part B
Situational hazards Tick Physical / chemical hazards Tick Health hazards Tick
Assault by person Y Contact with cold liquid / vapour Disease causative agent
Attack by animal Y Contact with cold surface Y Infection
Breathing compressed gas Contact with hot liquid / vapour Allergic reaction
Cold environment Y Contact with hot surface Lack of food / water
Crush by load Electric shock Y Lack of oxygen
Drowning Explosive blast Physical fatigue Y
Entanglement in moving machinery Explosive release of stored pressure Repetitive action
High atmospheric pressure Y Fire Static body posture
Hot environment Hazardous substance Stress / anxiety Y
Manual handling Y Ionizing radiation Venom poisoning
Object falling, moving or flying Laser light
Obstruction / exposed feature Lightning strike Y Environmental hazards
Sharp object / material Noise Y Litter Y
Shot by firearm Non-ionizing radiation Nuisance noise / vibration Y
Slippery surface Y Stroboscopic light Physical damage
Trap in moving machinery Vibration Waste substance released into air
Trip hazard Y Waste substance released into soil / water
Vehicle impact / collision Y Managerial / organisational hazards
Falls from height Management factors (lack of communication,
co-operation, co-ordination and competence)
Risk matrix – use this to determine risk for
each hazard i.e. ‘how bad and how likely’ Likelihood of Harm
Severity of Harm
Remote
e.g. <1 in 1000 chance
Very unlikely
e.g. 1 in 200 chance
Unlikely
e.g. 1 in 50 chance
Possible
e.g. 1 in 10 chance
Likely
e.g. >1 in 3 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:
Footage captured of students completing work in a classroom
Footage captured of a family enjoying a meal in a dining room
Footage captured of a character walking through a park
Location – where this activity will take place:
Bede Campus, Sunderland college (Media room 126)
P Griffin personal address (details on file)
Barnes Park, Sunderland
Dates / times:
14/01/22 9-10am
15/01/22 – 3-5pm
19/01/22: 9-11am
22/01/22 – 5-7pm
Hazards2
List what could cause harm from this activity
e.g. falls from height, trip hazard, fire, etc.
Who exposed
List who might be harmed
from this activity
e.g. staff, contractors,
contributors, public, etc.
Risk3
For each hazard, decide
level of risk as if you were to
do the activity without your
controls
Control measures
For each hazard, list the measures you will be taking to minimise the risk identified
e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective
equipment, provision of first aid, etc.
Risk3
For each hazard,
decide level of risk
once all your controls
are in place
Cold Environment Actors, Producer Likely, Slight A scene is to be shot outside in January. Temperatures are low. Crew will be informed of the
need to wear suitable clothing. When deciding on costume for actors, suitable warm clothing
will be chosen. Filming will be taking place near to a coffee shop where cast/crew can visit
should the weather be too harsh. Met office app will be consulted to ensure the weather is
suitable on proposed filming days.
Likely, Negligible
Trip Hazards Producer Possible, Slight In any internal scenes (my room), care will be taken to ensure that there are no trip hazards
caused by props, furniture or filming set ups. Cast and crew will have run throughs of scenes
to ensure all walkways are clear.
Very Unlikely,
Negligible
Stress/Anxiety Actors Possible, Slight Care will be taken to ensure all actors performing in front of the camera are comfortable.
Scripts will be provided well in advance to alleviate pressure for any dialogue to be learnt.
Meetings will take place prior to filming to ensure all are happy with plans. Run throughs will
take place to put actors at ease.
Unlikely,
Negligible
Electric Shock Actors, Producer,
Camera Crew
Unlikely, Moderate A scene will be shot of me playing on the machines, there is a small possibility that one of the
machines may break and give me an electric shock. In order to reduce this risk, I will make
sure I’m not playing on broken machines that could be dangerous. I will also make sure to not
touch any plug sockets.
Very Unlikely,
Slight
Assault by a Person Actors, Camera Crew,
Producer
Possible, Negligible If I am shooting a scene outside there is a small chance, I might run into a dodgy person who
might attack me. In order to prevent this, I will be aware of my surrounding and not go
anywhere dangerous (Back Alley). I will make sure I film in the day in order to reduce this
possibility.
Very Unlikely,
Negligible
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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Risk Assessment Template (Exemplar).docx

  • 1. Risk Assessment Form – Part A Production Name: Sunderland Culture – Content Creation Documentary Organisation Sunderland College Creative Media Production Address: Durham Road, Sunderland, SR3 4AH Sunderland Bowl 141 High St W, Sunderland England SR1 1TR Producer / Editor Tel: Mobile: Elliot Daroczy 07398616881 07398616881 Start date 07/01/23 End date 23/02/23 Distribution Who gets a copy of the assessment Neil Wilson, Emma Leslie-Boddy Outline of risk assessment Summary of what is proposed in terms of sequences and set ups. My camera and tripod will be taken outside to Sunderland Bowl for proposed shots: Me Playing in the arcade Me Recording the Machines Team members / experts / contractors / contributors etc. List those involved Elliot Daroczy Locations Outline locations involved – indicate any which are hostile environments Sunderland College – Media Classroom (VPA 126) My House – Sunderland Sunderland City Centre Assessor Name Signature Date completed 22/11/22 Authoriser Name (if not Assessor) Signature Date authorised 22/11/22 Hazard list – select your hazards from the list below and use these to complete Part B Situational hazards Tick Physical / chemical hazards Tick Health hazards Tick Assault by person Y Contact with cold liquid / vapour Disease causative agent Attack by animal Y Contact with cold surface Y Infection Breathing compressed gas Contact with hot liquid / vapour Allergic reaction Cold environment Y Contact with hot surface Lack of food / water Crush by load Electric shock Y Lack of oxygen Drowning Explosive blast Physical fatigue Y Entanglement in moving machinery Explosive release of stored pressure Repetitive action High atmospheric pressure Y Fire Static body posture Hot environment Hazardous substance Stress / anxiety Y Manual handling Y Ionizing radiation Venom poisoning Object falling, moving or flying Laser light Obstruction / exposed feature Lightning strike Y Environmental hazards Sharp object / material Noise Y Litter Y Shot by firearm Non-ionizing radiation Nuisance noise / vibration Y Slippery surface Y Stroboscopic light Physical damage Trap in moving machinery Vibration Waste substance released into air Trip hazard Y Waste substance released into soil / water Vehicle impact / collision Y Managerial / organisational hazards Falls from height Management factors (lack of communication, co-operation, co-ordination and competence) Risk matrix – use this to determine risk for each hazard i.e. ‘how bad and how likely’ Likelihood of Harm Severity of Harm Remote e.g. <1 in 1000 chance Very unlikely e.g. 1 in 200 chance Unlikely e.g. 1 in 50 chance Possible e.g. 1 in 10 chance Likely e.g. >1 in 3 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
  • 2. Very Severe e.g. death, permanent disability Low Medium High Extremely high Extremely high
  • 3. Risk Assessment Form – Part B Activity1 – Each individual activity you are proposing: Footage captured of students completing work in a classroom Footage captured of a family enjoying a meal in a dining room Footage captured of a character walking through a park Location – where this activity will take place: Bede Campus, Sunderland college (Media room 126) P Griffin personal address (details on file) Barnes Park, Sunderland Dates / times: 14/01/22 9-10am 15/01/22 – 3-5pm 19/01/22: 9-11am 22/01/22 – 5-7pm Hazards2 List what could cause harm from this activity e.g. falls from height, trip hazard, fire, etc. Who exposed List who might be harmed from this activity e.g. staff, contractors, contributors, public, etc. Risk3 For each hazard, decide level of risk as if you were to do the activity without your controls Control measures For each hazard, list the measures you will be taking to minimise the risk identified e.g. appointing competent persons, training received, planning and rehearsals, use of personal protective equipment, provision of first aid, etc. Risk3 For each hazard, decide level of risk once all your controls are in place Cold Environment Actors, Producer Likely, Slight A scene is to be shot outside in January. Temperatures are low. Crew will be informed of the need to wear suitable clothing. When deciding on costume for actors, suitable warm clothing will be chosen. Filming will be taking place near to a coffee shop where cast/crew can visit should the weather be too harsh. Met office app will be consulted to ensure the weather is suitable on proposed filming days. Likely, Negligible Trip Hazards Producer Possible, Slight In any internal scenes (my room), care will be taken to ensure that there are no trip hazards caused by props, furniture or filming set ups. Cast and crew will have run throughs of scenes to ensure all walkways are clear. Very Unlikely, Negligible Stress/Anxiety Actors Possible, Slight Care will be taken to ensure all actors performing in front of the camera are comfortable. Scripts will be provided well in advance to alleviate pressure for any dialogue to be learnt. Meetings will take place prior to filming to ensure all are happy with plans. Run throughs will take place to put actors at ease. Unlikely, Negligible Electric Shock Actors, Producer, Camera Crew Unlikely, Moderate A scene will be shot of me playing on the machines, there is a small possibility that one of the machines may break and give me an electric shock. In order to reduce this risk, I will make sure I’m not playing on broken machines that could be dangerous. I will also make sure to not touch any plug sockets. Very Unlikely, Slight Assault by a Person Actors, Camera Crew, Producer Possible, Negligible If I am shooting a scene outside there is a small chance, I might run into a dodgy person who might attack me. In order to prevent this, I will be aware of my surrounding and not go anywhere dangerous (Back Alley). I will make sure I film in the day in order to reduce this possibility. Very Unlikely, Negligible 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