Risk Assessment Template | Safesite Library

	A	B	C	D	E	F	G	H	I	J
1		Risk Assessment Matrix					Go to File > Make a Copy or File > Download to access an editable version
2
3		Change Details
4	Change Name	What change will you be assessing?
5	Proposed Date/Date Range of Change	Enter date
6	Change Manager/Owner:	Enter name and/or title
7	Affected Roles:	List affected roles
8	Are current and proposed processes attached?	Yes/No/N/A
9
10		Likelihood
11	Consequences	Almost never	Unlikely	Likely	Very Likely	Often to Almost Always		How to Use
12	Negligible Consequences	Very Low	Very Low	Low	Low	Medium		1. Create a spreadsheet describing the work environment or change to be assessed. Use the Risk Assessment Template.
13	Minor Consequences	Very Low	Low	Medium	Medium	High		2. List affected roles
14	Major Consequences	Low	Medium	High	High	Very High		3. List tasks (risk items) and use matrix to evaluate potential risk
15	Catastrophic Consequences	Medium	High	High	Very High	Very High		4. Identify a strategy to mitigate, replace, or reduce risk.
16
17
18	Manage your safety program for free with Safesite
19
20	Risk Indentification							Response Strategy
21	Risk Item / ID	Risk Description	Risk Type	Potential Impact (Catastrophic, Major, Minor, Negligable)	Probability of Impact (Highly Likely, Likely, Unlikely, Highly Unlikely)	Impact Area	Risk Matrix Results	Risk Owner	Strategy to Mitigate	Action taken
22	1						HIGH
23	2						MEDIUM
24	3						LOW
25	4
26	5
27	6
28	7
29	8
30	9
31	10
32	11
33	12
34	13
35	14
36	15
37	16
38	17
39	18
40	19
41	20
42	21
43	22
44	23
45	24
46	25
47	26
48	27
49	28
50	29
51	30
52	31
53	32
54	33
55	34
56	35
57	36
58	37
59	38
60	39
61	40
62	41
63	42
64	43
65	44
66	45
67	46
68	47
69	48
70	49
71	50
72	51
73	52
74	53
75	54
76	55
77	56
78	57
79	58
80	59
81	60
82	61
83	62
84	63
85	64
86	65
87	66
88	67
89	68
90	69
91	70
92	71
93	72
94	73
95	74
96	75
97	76
98	77
99	78
100	79