RISK ASSESSMENT MATRIX TEMPLATE

Company: [COMPANY NAME]
Assessment Date: [DATE]
Assessed by: [NAME & POSITION]
Review Date: [DATE]

INSTRUCTIONS:
1. Identify all hazards in the workplace or activity
2. Determine who might be harmed and how
3. Evaluate the risk using the matrix below
4. Decide on control measures
5. Record findings and implement controls
6. Review and update regularly

RISK ASSESSMENT MATRIX:

LIKELIHOOD SCALE:
1 - Rare: May occur only in exceptional circumstances
2 - Unlikely: Could occur at some time
3 - Possible: Might occur at some time
4 - Likely: Will probably occur in most circumstances
5 - Almost Certain: Expected to occur in most circumstances

CONSEQUENCE SCALE:
1 - Negligible: No injuries, minimal impact
2 - Minor: First aid treatment, minor impact
3 - Moderate: Medical treatment required, moderate impact
4 - Major: Extensive injuries, major impact
5 - Catastrophic: Death or permanent disability, severe impact

RISK RATING = LIKELIHOOD × CONSEQUENCE

DETAILED RISK MATRIX TABLE:

                    LIKELIHOOD →
CONSEQUENCE ↓    | Rare(1) | Unlikely(2) | Possible(3) | Likely(4) | Almost Certain(5)
─────────────────|─────────|─────────────|─────────────|───────────|──────────────────
Catastrophic (5) |    5    |     10      |     15      |    20     |        25
Major (4)        |    4    |      8      |     12      |    16     |        20
Moderate (3)     |    3    |      6      |      9      |    12     |        15
Minor (2)        |    2    |      4      |      6      |     8     |        10
Negligible (1)   |    1    |      2      |      3      |     4     |         5

RISK LEVELS:

LOW RISK (1-6): GREEN ZONE
• Monitor and maintain existing controls
• Review periodically
• Document current controls
• No immediate action required

MEDIUM RISK (7-12): YELLOW ZONE  
• Additional controls may be required
• Implement controls within reasonable timeframe
• Increase monitoring frequency
• Consider cost-effective improvements
• Target completion within 30-90 days

HIGH RISK (13-25): RED ZONE
• Immediate action required to reduce risk
• Stop work if imminent danger exists
• Implement interim controls immediately
• Develop comprehensive control plan
• Target completion within 1-30 days
• Senior management notification required

RISK ASSESSMENT FORM:

Hazard ID: [001]
Hazard Description: [Describe the hazard]
Location: [Where is the hazard located]
Who might be harmed: [Workers, visitors, contractors, etc.]
How harm could occur: [Describe potential incidents]

Current Controls:
• [List existing control measures]
• [Include PPE, procedures, training, etc.]

Risk Evaluation:
Likelihood: [1-5]
Consequence: [1-5]
Risk Rating: [L × C]
Risk Level: [Low/Medium/High]

Additional Controls Required:
• [List additional measures needed]
• [Assign responsibility and timeline]
• [Include training, equipment, procedures]

Residual Risk:
Likelihood: [1-5]
Consequence: [1-5]
Risk Rating: [L × C]
Risk Level: [Low/Medium/High]

Action Plan:
Action Required: [Specific action]
Responsible Person: [Name]
Target Date: [Date]
Completion Date: [Date]
Status: [Not Started/In Progress/Complete]

Review Information:
Next Review Date: [Date]
Trigger for Review: [Annual/Incident/Change in process]
Reviewed by: [Name & Position]

HIERARCHY OF CONTROLS (Apply in order of preference):
1. ELIMINATION - Remove the hazard completely
2. SUBSTITUTION - Replace with something less dangerous
3. ENGINEERING CONTROLS - Isolate people from hazard
4. ADMINISTRATIVE CONTROLS - Change work practices
5. PPE - Personal protective equipment (last resort)

COMMON WORKPLACE HAZARDS CHECKLIST:
□ Slips, trips, and falls
□ Manual handling
□ Machinery and equipment
□ Electrical hazards
□ Chemical substances
□ Fire and explosion
□ Working at height
□ Confined spaces
□ Noise and vibration
□ Temperature extremes
□ Biological hazards
□ Psychosocial factors
□ Vehicle movements
□ Radiation
□ Violence and aggression

DOCUMENTATION REQUIREMENTS:
• Keep records of all risk assessments
• Make assessments available to affected workers
• Review when circumstances change
• Update following incidents or near misses
• Ensure assessments are signed and dated

Assessor Signature: _________________ Date: _________
Manager Approval: _________________ Date: _________

Document Control:
Version: 1.0
Document ID: RA-TEMPLATE-001
Next Review: [DATE]