Risk Assessment Form – Part A Blank Template

Reference: None required Sign-off status Approved

Assessment summary details

Assessment title *(Simple name for reference purposes)

“Put Your Records On” music video

Division:* Production Department:* Media

Series/ Prod/Unit: Music video Programme/Area:

Responsible Manager: Mariel Racaza

Eiriel De Roxas

Contact office: Netherhall School and Sixth Form Centre

Address/Tel: 10 Long Reach Road

CB4 1UH

13 Spalding Way

CB1 8NP

Address/Tel: Queen Edith’s Way

CB1 8NN

01223242931

Date assessment created

14/10/2014 Confidential risk assessment?

NO

Assessment Outline(Summary of what is proposed)

The filming of a music video, to check that the locations are safe to use

Assessment start date 14/10/2014 Review / End date 15/10/2014

Country location England Hostile / travel advisory?

NO

Location details Lion Yard

CB2 3ET

New Square Park

CB1 1EY

Netherhall School

CB1 8NN

13 Spalding Way

CB1 8NP

NB: If the country location selected is ‘Hostile’ you are required to: complete the BBC Overseas High Risk Assessment Form

Crew / team(Roles, responsibilities, competencies)

Mariel Racaza – Director

Eiriel De Roxas – Cameraman

Kevin Racaza – Cameraman

Julie Nasayao – Lighting Assistant

Jason Garcia – Crew hands

Attachments(Detail supporting documents)

Assessor(s) *(Person drafting risk assessment)

Mariel Racaza

Eiriel De Roxas

Assessor safety competence

Medium

Authoriser(s) *(Person responsible for sign-off)

Mr Day Date signed-off * 15/10/2014

Distribution(Who gets a copy of the assessment)

Data Protection Act: Personal information collected for the purposes of risk assessment will be used to identify those at risk, and those involved in controlling risk, from this or similar activities and to fulfil the BBC's obligations under Health and Safety policy and legislation. It will be retained for up to 6 years after the expiry of the activity. It may be shared with other organisations, including our agents and contractors, with whom the risk or the control of risk is shared.

[* mandatory fields]

Activity and Hazard Summary [This is a summary of the activities listed in part B of the risk assessment.]

Activity Who Exposed Hazards{hazard titles Activity Risk Rating

Filming in the park Cast, crew and bystanders Bystanders could kick the tripod and damage it

People playing with a ball in the park could kick the ball and hurt the cast/crew and break equipment

LOW

LOW

Filming in city streets Cast, crew and bystanders Bystanders could kick the tripod and damage it

Cars passing could get distracted.

Cars could hit crew members, bystanders, and actors.

LOW

LOW

MEDIUM

Filming in the media studio Cast and crew Cast and crew could trip over tripods and wires

LOW

Filming in a living room Cast and crew Cast and crew could trip over tripods, wires and plugs

Owner of the house has a dog and it might disrupt the flow of filming

Figurines displayed could get knocked over.

LOW

MEDIUM

LOW

Comments log

Who by Date / time received

Comments Assessor response Date/ time responded

[* mandatory fields]

Risk Assessment Form – Part B Blank Template

6Reference: None required Sign-off status Approved

ACTIVITIES: What are you doing, where, for how long and who will be involved? Complete the fields in the form below).

HAZARDS & CONTROLS: How could someone become hurt or made ill and how are you going to prevent this from happening?

Activity Title:* Sitting in the park and lip syncing

Activity Description: Two actors sitting in the park being intimate. One of them lip syncs.

List those managing this Activity and their competence:

Mariel Racaza – DirectorEiriel De Roxas – DirectorKevin Racaza – CameramanJulie Nasayao – Lighting Assistant

Who & how many are at risk from this Activity?

Cast and crew

HazardsHow could someone become hurt or made ill

Control measuresHow are you going to prevent this from happening?

Bystanders could kick the tripod and damage it. Keep a lookout for bystanders that are near and make sure to keep a careful eye on the tripod.

People playing with a ball in the park could kick the ball and hurt the cast/crew and break equipment.

Move away from people playing with a ball.

Risk Level*: After your controls have been applied what is your assessment of the risk level of this activity?

Low

[* mandatory fields]

Risk Assessment Form – Part B Blank Template

6Reference: None required Sign-off status Approved

ACTIVITIES: What are you doing, where, for how long and who will be involved? Complete the fields in the form below).

HAZARDS & CONTROLS: How could someone become hurt or made ill and how are you going to prevent this from happening?

Activity Title:* Walking through the city

Activity Description: Actors walking in the streets with one of them lip syncing.

List those managing this Activity and their competence:

Mariel Racaza – DirectorEiriel De Roxas – DirectorKevin Racaza – CameramanJulie Nasayao – Lighting Assistant

Who & how many are at risk from this Activity?

Cast and crew

HazardsHow could someone become hurt or made ill

Control measuresHow are you going to prevent this from happening?

Bystanders could kick the tripod and damage it. Keep a lookout for bystanders that are near and make sure to keep a careful eye on the tripod.

Cars passing could get distracted. Having a crew member to have as a lookout to make sure we don’t distract the drivers.

Cars could hit crew members, bystanders, and actors. Having a crew member to have as a lookout and make sure to film away from traffic. Tell crew members and actors to lookout and stay away from traffic.

Risk Level*: After your controls have been applied what is your assessment of the risk level of this activity? Low

[* mandatory fields]

Risk Assessment Form – Part B Blank Template

6Reference: None required Sign-off status Approved

ACTIVITIES: What are you doing, where, for how long and who will be involved? Complete the fields in the form below).

HAZARDS & CONTROLS: How could someone become hurt or made ill and how are you going to prevent this from happening?

Activity Title:* Living room

Activity Description: Actor is sitting by the window lip syncing. She gets up and walks away.

List those managing this Activity and their competence:

Mariel Racaza – CamerawomanEiriel De Roxas – DirectorJulie Nasayao – Lighting Assistant

Who & how many are at risk from this Activity?

Cast and crew

HazardsHow could someone become hurt or made ill

Control measuresHow are you going to prevent this from happening?

Cast and crew could trip over tripods and plugs Make sure to keep the plugs out of the way and remove tripods when not needed.

Owner of the house has a dog and it might disrupt the flow of filming Keep the dog away, preferably a separate room.

Figurines displayed could get knocked over Put away from the filming site during filming and make sure the crew members and actors are aware of their surroundings.

Risk Level*: After your controls have been applied what is your assessment of the risk level of this activity? Low

[* mandatory fields]

Risk Assessment Form – Part B Blank Template

6Reference: None required Sign-off status Approved

ACTIVITIES: What are you doing, where, for how long and who will be involved? Complete the fields in the form below).

HAZARDS & CONTROLS: How could someone become hurt or made ill and how are you going to prevent this from happening?

Activity Title:* Projected wall and plain background

Activity Description: Actor is leaning against the wall, lip syncing.

List those managing this Activity and their competence:

Mariel Racaza – CamerawomanEiriel De Roxas – DirectorJulie Nasayao – Lighting Assistant

Who & how many are at risk from this Activity?

Cast and crew

HazardsHow could someone become hurt or made ill

Control measuresHow are you going to prevent this from happening?

Cast and crew could trip over tripods Make sure to keep the tripods out of the way and remove when not needed.

Risk Level*: After your controls have been applied what is your assessment of the risk level of this activity?

Low

[* mandatory fields]