Machine Guarding Risk Assessment Form
Form - Version 2
Machine Guarding Risk Assessment Form · FORM-31349
Procedure for undertaking a risk assessment
Risk assessment form guidance sheet
Stage 1: Introduction
Stage 2: Hazard identification
Stage 3: Risk control
Stage 4: Monitor and review
Summary: key outcomes
Hierarchy of controls
Risk matrix
Step 1: Determine likelihood
Likelihood | Criteria | Description |
|---|---|---|
Almost certain | ||
Likely | ||
Possible | ||
Unlikely | ||
Rare |
Step 2: Determine consequence
Step 3: Determine the risk score
| Consequence → | |||||
|---|---|---|---|---|---|
| Likelihood ↑ | InsignificantNo effect, or so minor that the effect is acceptable | MinorMinor first aid treatment, minimal business disruption, minimal environmental effect | ModerateSerious injuries, medium business interruption, medium environmental impact | MajorExtensive injuries or fatality, significant business interruption, environmental harm, prosecution | CatastrophicMultiple permanent disabilities or fatalities, business failure, substantial environmental harm, prosecution or imprisonment |
| Almost certainExpected in most circumstances | 2 M2 Moderate | 2 M2 Moderate | 3 H3 High | 4 A4 Acute | 4 A4 Acute |
| LikelyWill probably occur in most circumstances | 2 M2 Moderate | 2 M2 Moderate | 3 H3 High | 4 A4 Acute | 4 A4 Acute |
| PossibleCould possibly occur at some time | 1 L1 Low | 2 M2 Moderate | 2 M2 Moderate | 3 H3 High | 4 A4 Acute |
| UnlikelyUnlikely but possible | 1 L1 Low | 1 L1 Low | 2 M2 Moderate | 3 H3 High | 4 A4 Acute |
| RareHighly unlikely to occur | 1 L1 Low | 1 L1 Low | 2 M2 Moderate | 2 M2 Moderate | 3 H3 High |
- 1 L1 LowRecord and monitor. Proceed with work, and review the risks regularly.
- 2 M2 ModerateMaintain control measures. Be cautious when working, and monitor and review regularly.
- 3 H3 HighReview before commencing work. Introduce new controls or maintain high-level controls to lower the risk level, and monitor the controls frequently.
- 4 A4 AcuteDo not proceed until the risk level is reduced. Immediately introduce high-level controls, and re-assess before proceeding.
Step 4: Record risk
Risk assessment details
- Activity
- —
- Risk assessment no.
- —
- Company name
- [Company]
- Contact name
- —
- Position
- —
- Phone no.
- —
Risk assessment approved by
- Name/signature
- —
- Job title
- —
- Date
- —
Workplace details
- Location
- —
- No. of workers at the workplace
- —
Overall risk rating after controls
Assessor
- Assessor name / signature
- —
- Job title
- —
- Date
- —
Workers consulted
Name | Signature | Date |
|---|---|---|
Hazards and control measures
Evaluating safety features of new equipment
Reviewing maintenance and safety records of used equipment before purchase
Training in safe machine operation and guarding procedures
Ensuring machinery is operated by authorised and trained individuals
Regularly checking the safety features of machinery
Checking guard compliance with AS 4024 or relevant standards
Identifying areas with pinch points or nip hazards
Checking for flying debris during machinery operation
Ensuring emergency stops are positioned and accessible
Evaluating exposure to moving parts
Checking for sharp edges or blades
Evaluating electrical hazards
Ensuring proper installation and fastening of guards
Evaluating machinery noise levels
Evaluating ergonomic hazards
Assessing risks of slips, trips, and falls around machinery
Evaluating the condition of machine guards
Managing LOTO (Lockout/Tagout) permits
Reviewing historical incidents associated with machinery
Safely decommissioning and disposing of old or unsafe machinery
Other
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Machine Guarding Risk Assessment Form · FORM-31349