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Risk Assessment Form – Part A Blank Template
Reference: None required Sign-off status [planning/approved etc]
Assessment summary details
Assessment title *(Simple name for reference purposes)
Sweet Encounters opening sequence
Division:* Production Department:* Media
Series/ Prod/Unit:Opening Sequence
Programme/Area:
Responsible Manager:
Mariel Racaza
Patricia Dacasin Contact office:
Netherhall School and Sixth Form Centre
Address/Tel: 10 Long Reach Road
CB4 1UH
54 Wulfstan Way
CB1 8QH
Address/Tel: Queen Edith’s Way
CB1 8NN
01223242931
Date assessment created
20/11/13 Confidential risk assessment?
NO
Assessment Outline(Summary of what is proposed)
The filming of an opening sequence of a film, to check that the location is safe to use.
Assessment start date
20/11/13 Review / End date
30/11/13
Country locationEngland
Hostile / travel advisory?
NO
Location details 54 Wulfstan Way
CB1 8QH
59 Regent Street
CB2 1AB
Cherry Hinton Road
CB1 8DW
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 – Camerawoman
Patricia Dacasin - Director
Attachments(Detail supporting documents)
Assessor(s) *(Person drafting risk assessment)
Mariel Racaza Assessor safety
competence
Medium
Authoriser(s) *(Person responsible for sign-off)
Mr Sheppard/Mr Day Date signed-off *
Distribution(Who gets a copy of the assessment)
Production Crew
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.
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Risk Assessment Form – Part A Blank Template
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 living room Cast and Crew Tripping over wires and knocking over the tripod.
LOW
Filming in Café Sicilia Cast, crew and bystanders Bystanders could kick the tripod and damage it.
MEDIUM
Comments log
Who by Date / time received
Comments Assessor response Date/ time responded
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Risk Assessment Form – Part B Blank Template
6Reference: None required Sign-off status [planning/approved etc]
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:* Talking
Activity Description:Two people talking in a living room with both of them sitting on the sofa.
List those managing this Activity and their competence:
Mariel Racaza – CamerawomanPatricia Dacasin - Director
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?
Actors could trip over wires and knock the tripod down. Put wires away to the side.
Risk Level*: After your controls have been applied what is your assessment of the risk level of this activity?
Low
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Risk Assessment Form – Part B Blank Template
6Reference: None required Sign-off status [planning/approved etc]
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:* Buying coffee and walking
Activity Description:Actor buying coffee at the counter and turning around to walk away.
List those managing this Activity and their competence:
Mariel Racaza – CamerawomanPatricia Dacasin - Director
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.
Risk Level*: After your controls have been applied what is your assessment of the risk level of this activity?
Low
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