1. How to Supervise Evaluate
OPERATIONAL RISK ASSESSMENT WORKSHEET
Mission/Task:
Mission Date:
Date Prepared:
Page:
Prepared By: Personnel & Position
Phase of Mission or Task:
Step 3
Develop Controls &
Make Risk Decisions
Step 1
Identify Hazard
Step 2
Assess
Hazard
Residual
Risk
Step 4
How to Implement
Step 5
How to Supervise Evaluate
Evaluate (AAR)
Risk Decision Authority:
Determine overall mission/task risk level after controls are implemented (Circle one):
LOW (L)
MODERATE (M)
HIGH (H)
EXTREMELY HIGH (E)

2. SAMPLE OPERATIONAL RISK ASSESSMENT WORKSHEET I. M. Tough Mission/Task:1 2
Mission/Task:
Mission Date:
Date Prepared: 3
Page: 4
Film Water Safety Video at
Oura
Wan Beach
26 Jan 09
16 Jan 09
1 of 1 5
Prepared By: Personnel & Position
Shawn Curtis, Occupational Safety & Health Specialist 6
Phase of Mission or Task:
Entire evolution of activity
Step 1
Step 2
Step 3
Assess
Residual
Step 4
Step 5
Evaluate
Identify Hazard
Hazard
Develop Controls
Risk
How to Implement
How to Supervise
(AAR) 7 8 9 10 11 12
Safety Specialist/ Water 13
Provide lifeguard support. Have
Coordinate w/ local MCCS
Safety & Lifeguard
Wave surges
SAMPLE
B-I
RAC-1
safety boats in water. Keep Rescue
B-III RAC-3
lifeguards to assist. Utilize
Instructor on site. Rescue
equip. on site to include Blankets,
only experienced swimmers
first aid kit, O2, & spine board
boats with operators &
in the water for scenes.
lifeguards
Coordinate w/ local MCCS
Safety Specialist/ Water
A-I RAC-1
Contact Japanese weather service
C-III
RAC-4
lifeguards to assist. Utilize
Safety & Lifeguard
Currents
for conditions. Inform RAS of
only experienced swimmers
Instructor on site. Rescue
activities on beach.
in the water for scenes. Stay out
boats with operators &
of water if conditions are unsafe.
lifeguards
B-1 RAC-1
Contact Japanese weather service
Safety Specialist/ Water
Do enter water during
hazardous sea states .
Sea Conditions
&
Oura
Wan Boating for
C-III
RAC-4
Safety & Lifeguard
conditions.
Instructor and Boating
Manager on site.
Ensure people are clear of the
Launching &
boat, trailer & vehicle during
Have boat staff conduct
Safety Specialist/ Water
C-II RAC-3
launching& recovering operations.
D-III
RAC-5
launch & recover
Safety & Lifeguard
recovering
Utilize radios during boating
operations. Train people who
Instructor and Boating
Watercraft
operations to keep comm. with boat
will assist prior to task.
Manager on site.
house.
Risk Decision Authority:
Determine overall mission/task risk level after controls are imp
lemented (Circle one): 15 14
I. M. Tough
LOW (L)
MODERATE (M)
HIGH (H)
EXTREMELY HIGH (E)

3. OPERATIONAL RISK ASSESSMENT WORKSHEET GUIDE
BLOCK
1. Mission/Task – Briefly describe the intent of the activity.
2. Mission date – Enter date when the activity is planned to begin and when it is planned to be completed.
3. Date prepared – Enter year/month/day the worksheet was prepared.
4. Page – Enter the page number. Depending on the number of hazards identified, you may have additional pages.
5. Prepared by – Enter the rank, last name and position of the person who prepared the worksheet.
6. Phase of mission or task – Put the portion of the activity being conducted.
7. Identify hazards – Identify hazards that are most likely to result in accidental injury, damage, or mission degradation.
8. Assess hazards – Determine the risk of each hazard by applying the Risk Assessment Code for each hazard. Use the
Risk Assessment Matrix to get the code.
9. Develop controls – For each hazard, develop one or more controls to eliminate or reduce the risk.
10. Determine residual risk – For each hazard, determine the Risk Assessment Code to establish the level once the
control measures are identified. Use the Risk Assessment Matrix.
11. Implement controls – For each control listed in block 9 how will it be put into effect and/or communicated to the
personnel who will make it happen.
12. Supervise – Enter how each control will be monitored to ensure it is implemented.
13. Evaluate – After the exercise is completed, determine the effectiveness of each control to reduce the risk of the
targeted hazard. Enter “yes” if the control was effective. Enter “no” if the control was not effective. For each control
that was not effective, determine why and document what to do the next time this hazard is identified.
14. Overall risk level after controls are implemented – This is the same as the hazard with the highest residual risk for
the exercise.
15. Risk decision authority – Enter the rank, name, and position of the decision making authority for the level of risk
involved in block 13.

4. 2 A 1 3 4 5 I II III IV B C D RISK ASSESSMENT MATRIX
Probability
A - Likely to occur immediately
or within short period of time.
B - Probably will occur in time.
C - May occur in time.
D - Unlikely to occur.
Severity
I - May cause death, loss of
facility/asset.
II - May cause sever injury
illness, property damage.
III - May cause minor injury,
IV – Minimal threat.
RISK
ASSESSMENT
MATRIX
1. Accept risk when the benefit is greater than the cost.
2. Accept no unnecessary risk.
3. Anticipate and manage risk by planning.
4. Make risk decisions at the right level 2 A
Likely 1 3 4 5 I II
III IV B
Probable C
May D
Unlikely
P R O B A B I L I T Y
Risk
ASSESSMENT
Matrix
MCO B
Death,
Loss of Asset
Severe Injury,
Damage
Minor Injury,
Minimal
Threat
1-Critical 2-Serious 3-Moderate 4-Minor 5-Negligible
S E V E R I T Y