RISK ASSESSMENT RECORDING FORM

Location or Address: Back garden, tra !o"ine Acti,it* or Sit)ation Ca!t)ring !+oto-s
/(0 1a2ard Risk

Date Assess ent #ndertaken: $%&'$&(% Re,ie. Date: n&a

/$0 3+o ig+t 4e +ar ed and +o.5

Assess ent )ndertaken B*: Natas+a Signat)re

/60 3+at contro"s e7ist to red)ce risk

/%0 3+at action can 4e taken to 8)rt+er red)ce risk5

Could fall through the trampoline when jumping. Trip over metal bars

4-5 1-4

Anyone on the trampoline Anyone near the trampoline, moving around

is! rating ". #ip up the $ip and ma!e sure there%s no holes to fall through. is! rating 4-5 &ove around 'arefully, and wat'h your step. (on%t rush )la'e something hard on the edge of the trampoline to stand on so you want fall through.

(on%t jump on the trampoline *eep at least 1m away from the trampoline

Could fall through the edge of the trampoline

RISK RATING a SE9ERIT: ; % 6 $ ( D*ing or 4eing !er anent"* disa4"ed Serio)s in?)r*&"ong ter i""ness

1-4

Anyone around the edge of the trampoline

+ot stand on the edge of the trampoline

4 LIKELI1OOD ; % 6 $ ( 3i"" a" ost certain"* +a!!en 1ig+"* "ike"* to +a!!en Not so "ike"* E,en "ess "ike"* #n"ike"* to +a!!en at a""

c FINAL SCORE RATING: .+at needs to 4e done (<=$; Sto!> Do not start acti,it* again )nti" risk is contro""ed ('=(; 1ig+ risk "e,e", 1ig+ !riorit*@ Take action straig+t a.a* to contro" t+e risk <=A Medi) risk "e,e"@ Tig+ten )! contro"s and ake a !"an to do so et+ing a4o)t risk 6=; Fair"* "o. risk "e,e"@ Lo. !riorit* 4)t kee! !ossi4"e action in ind (=$ Lo. or tri,ia" risk@ No 8)rt+er action reB)ired@

Te !orar* disa4i"it*&6 da*s o88 sick 3i"" need edica" attention

Minor in?)r* eg@ Br)ise, gra2e

SO: a 7 4 C c
Action ReB)ired Res!onsi4"e Derson Date 8or Co !"etion