HFORM01: Risk Assessment Template¶

Form Reference: HFORM01 Version: 1.0 Classification: CRGI Information Form Owner: Sean Ashton, Operations Manager Purpose: Comprehensive risk assessment using L×C methodology per HPROC01. Documents systematic identification, evaluation and management of workplace hazards and risks.

Document Control¶

Version	Date	Author	Change Summary
1.0	10/03/2026	Sean Ashton	Initial issue

1. Assessment Details¶

Field	Details
Assessment ID	RA-YYYY-___
Assessment Date	_________________
Assessment Type	☐ Initial ☐ Review ☐ Periodic ☐ Incident-Triggered ☐ Change-Related
Lead Assessor	_________________
Assessment Scope	_________________
Trigger/Reason	_________________

2. Risk Assessment Methodology¶

CRGI Solutions uses a 5×5 Likelihood × Consequence (L×C) methodology per HPROC01

Likelihood Scale (1–5)¶

Rating	Level	Description	Frequency
1	Rare	Almost impossible to occur	< 1 in 10 years
2	Unlikely	Could occur but unusual	1–5 in 10 years
3	Possible	May occur at some time	1 in 1–5 years
4	Likely	Expected to occur periodically	> 1 per year
5	Almost Certain	Very likely to occur	Multiple times per year

Likelihood Rating: ____

Consequence Scale (1–5)¶

Rating	Level	Description	Impact
1	Negligible	No injury/ill-health, minimal impact	Minor cuts/bruises, < £5k cost
2	Minor	Small injury/ill-health, limited impact	Minor injuries, £5–20k cost
3	Moderate	Medical treatment required, detectable impact	Significant injury, £20–100k cost, short-term absence
4	Major	Serious injury/ill-health, significant impact	Serious injury/illness, £100k–500k cost, extended absence
5	Catastrophic	Death or serious permanent damage, major impact	Fatality or permanent disability, >£500k cost, reputational damage

Consequence Rating: ____

3. Hazard & Risk Identification¶

Activity	Hazard	Who at Risk	Existing Controls
_________________	_________________	_________________	_________________
_________________	_________________	_________________	_________________
_________________	_________________	_________________	_________________

4. Likelihood Assessment¶

For each identified hazard, determine likelihood (1–5) based on frequency and probability.

Hazard	Likelihood Rating (1–5)	Justification
_________________	____	_________________
_________________	____	_________________
_________________	____	_________________

5. Consequence Assessment¶

For each identified hazard, determine consequence (1–5) based on potential impact.

Hazard	Consequence Rating (1–5)	Justification
_________________	____	_________________
_________________	____	_________________
_________________	____	_________________

6. Risk Rating Calculation¶

Risk Rating = Likelihood × Consequence

Risk Matrix & Scoring¶

L / C	1 Negligible	2 Minor	3 Moderate	4 Major	5 Catastrophic
1 Rare	1	2	3	4	5
2 Unlikely	2	4	6	8	10
3 Possible	3	6	9	12	15
4 Likely	4	8	12	16	20
5 Almost Certain	5	10	15	20	25

Risk Levels¶

Score	Risk Level	Action Required
1–3	Very Low	Accept, monitor
4–6	Low	Manage with standard controls
7–12	Moderate	Enhance controls, review regularly
13–16	High	Significant control improvements required
17–25	Very High	Implement urgent controls, may restrict work

7. Current Risk Assessment¶

Hazard	Likelihood	Consequence	Initial Risk Rating	Risk Level
_________________	____	____	____	_________________
_________________	____	____	____	_________________
_________________	____	____	____	_________________

8. Additional Controls Recommendation¶

List additional or enhanced controls to reduce risk:

Control	Implementation Target	Responsibility	Estimated Cost
_________________	_________________	_________________	_________________
_________________	_________________	_________________	_________________

9. Residual Risk Rating¶

After proposed controls implemented:

Hazard	Residual Likelihood	Residual Consequence	Residual Risk Rating	Residual Risk Level
_________________	____	____	____	_________________
_________________	____	____	____	_________________

10. Risk Acceptance¶

Two-tier approval required:

CEO (Dragos Ciordas) approves High (13–16) and Very High (17–25) risk ratings
Operations Manager (Sean Ashton) approves Very Low to Moderate risk ratings

Risk Level	Acceptable as Is ☐	Acceptable with Controls ☐	Not Acceptable ☐	Approver	Date	Comments
_________________				_________________	_________________	_________________
_________________				_________________	_________________	_________________

11. Sign-Off¶

Role	Name	Signature	Date
Lead Assessor	_________________	_________________	_________________
Operations Manager	Sean Ashton	_________________	_________________
CEO (if High/Very High)	Dragos Ciordas	_________________	_________________

12. Register Update & Monitoring¶

☐ Risk recorded in HREG01 (Risk Register)
☐ Risk recorded in HREG03 (Hazard Register)
Risk Owner: _________________
Next Review Date: _________________
Monitoring Frequency:

☐ Monthly ☐ Quarterly ☐ Annually ☐ Event-triggered

Notes on monitoring and review:

HPROC01: Risk Assessment & Management Procedure
HPROC02: Hazard Identification & Control Procedure
HREG01: Risk Register
HREG03: Hazard Register

Retention: 5 years after assessment closure Storage: CRGI Secure Document Management System Access: Management, Lead Assessor, Risk Owner Classification: CRGI Information — Internal Use Only

END OF FORM