⚠  ILLUSTRATIVE SAMPLE — NOT FOR OPERATIONAL USE — CLIENT DETAILS ARE FICTIONAL  ⚠
Risk Assessment — Portfolio Sample
Prepared for
Document Type
Risk Assessment
Management of Health & Safety at Work Regulations 1999
Assessment Ref.
Date of Assessment
Review Date
Assessor
Version
1
Activity & Scope
Describe the task being assessed
2
Persons at Risk
Who could be harmed by this activity?
3
Hazard Identification & Risk Control
Likelihood × Severity — 1 (lowest) to 5 (highest)
Risk Rating: Score = Likelihood × Severity  |  1–4 LOW  5–9 MEDIUM  10–14 HIGH  15–25 VERY HIGH
# Hazard Persons at Risk L S Rating Control Measures L¹ S¹ Residual Action / By Whom Target Date
4
Risk Summary & Acceptability
—
—
5
Sign-Off & Review
Review required: Annually as a minimum, or following any incident / near miss, change of task, change of site, new hazard identified, or legislative change.
RoleFull NamePosition / QualificationsDate
Assessor (Prepared by)
Responsible Person (Client)
Assessor SignatureAuthorised via electronic delivery — AB SiteSafe
Client SignatureSign to confirm receipt and implementation of this assessment
Alexander Banister | ABSiteSafe@outlook.com | Professional Indemnity & Public Liability Insured
This risk assessment has been prepared by AB SiteSafe on behalf of the named client. It is the responsibility of the employer to ensure this assessment is implemented, communicated to workers, and reviewed as required. AB SiteSafe does not accept liability for actions or omissions following provision of this document.