The Life Safety Risk Assessment Form is a critical document required under New Zealand's health and safety regulatory framework. It is designed to be used when organizations need to conduct thorough evaluations of potential risks to human life within their facilities or operations. The form addresses requirements set out in the Health and Safety at Work Act 2015 and associated regulations, providing a systematic method for identifying hazards, assessing their potential impact, and determining appropriate control measures. This document should be completed during initial facility setup, after significant changes to operations, during periodic safety reviews, or when specific safety concerns arise. It includes comprehensive sections covering hazard identification, risk evaluation, control measures, emergency procedures, and compliance requirements, making it an essential tool for maintaining workplace safety and meeting legal obligations in New Zealand.
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1. Assessment Details: Basic information including date, location, assessor details, and scope of assessment
2. Site Information: Details of the property/facility being assessed, including address, building type, occupancy levels, and operating hours
3. Hazard Identification: Comprehensive list of potential life safety hazards identified during the assessment
4. Risk Assessment Matrix: Standard risk evaluation framework showing likelihood and consequence ratings
5. Risk Evaluation: Detailed analysis of each identified hazard using the risk matrix, including current control measures
6. Control Measures: Existing and recommended control measures to mitigate identified risks
7. Emergency Response: Assessment of emergency procedures, evacuation plans, and emergency equipment
8. Training and Competency: Evaluation of staff training needs and current competency levels related to life safety
9. Compliance Review: Assessment of compliance with relevant legislation and standards
10. Action Plan: Prioritized list of recommended actions with timeframes and responsibilities
1. Specific Equipment Assessment: Detailed assessment of specific high-risk equipment or machinery, used when the site contains specialized equipment
2. Chemical Risk Assessment: Assessment of hazardous substances and dangerous goods, included when chemicals are present on site
3. Working at Heights: Specific assessment for locations with elevated work areas or fall risks
4. Confined Spaces: Detailed assessment of confined space risks, included when confined spaces are present
5. Historical Incident Review: Analysis of previous incidents and near-misses, included when historical data is available
1. Floor Plans: Marked-up floor plans showing emergency exits, fire equipment, and high-risk areas
2. Photo Log: Photographic evidence of hazards and control measures identified during assessment
3. Risk Assessment Worksheets: Detailed worksheets showing calculations and methodology used in risk assessment
4. Equipment Register: List of safety-critical equipment and their maintenance schedules
5. Emergency Contact List: List of key personnel and emergency contacts
6. Compliance Certificates: Copies of relevant compliance certificates and inspection records
Authors
Relevant legal definitions
Clauses
Relevant Industries
Manufacturing
Construction
Healthcare
Education
Retail
Hospitality
Warehousing and Logistics
Mining and Resources
Agriculture
Commercial Property
Industrial
Public Sector
Transportation
Relevant Teams
Health and Safety
Operations
Facilities Management
Risk Management
Compliance
Quality Assurance
Emergency Response
Workplace Services
Building Management
Environmental Health and Safety
Relevant Roles
Health and Safety Manager
Risk Assessment Specialist
Facility Manager
Operations Manager
Safety Consultant
Compliance Officer
Building Services Manager
Workplace Health and Safety Officer
Environmental Health and Safety Coordinator
Site Manager
Project Manager
Quality Assurance Manager
Emergency Response Coordinator
Occupational Health and Safety Specialist
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