Person's Name (or generic risk title): [Person's Name (or generic risk title)]
Date of Assessment: [Date of Assessment]
Hazard Identified: [Hazard Identified]
Who Is at Risk?: [Who Is at Risk?]
Current Control Measures in Place: [Current Control Measures in Place]
Likelihood (1=Rare, 2=Unlikely, 3=Possible, 4=Likely, 5=Almost Certain): [Likelihood (1=Rare, 2=Unlikely, 3=Possible, 4=Likely, 5=Almost Certain)]
Severity (1=Negligible, 2=Minor, 3=Moderate, 4=Major, 5=Catastrophic): [Severity (1=Negligible, 2=Minor, 3=Moderate, 4=Major, 5=Catastrophic)]
Additional Controls Required: [Additional Controls Required]
Residual Risk Rating (after controls): [Residual Risk Rating (after controls)]
Review Date: [Review Date]
Assessor Name: [Assessor Name]
For assessing and managing risks to service users, staff, and others.
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