Estate Risk Report Form

Provide your name so the report can be clarified or followed up. If anonymous reporting is permitted, leave this blank.

For example, teacher, teaching assistant, site staff, pupil or visitor.

Enter the date on which the risk was reported.

Describe what was observed, what is wrong and why it may cause harm. Include relevant details such as damage, obstruction, defect, spill, unsafe condition or access problem.

Select all that apply. Use the other option to identify a specific area or feature not listed.

Give the building, room, floor, entrance, route, playground, car park or other precise location. Include a nearby landmark if useful.

If known, enter when the risk was first observed. If it has been present for an unknown period, use the date reported.

Select all groups that could be exposed to the risk.

Describe what could happen if the risk is not controlled, such as a fall, collision, exposure, loss of access or damage. Do not assign a numerical risk score in this form.

Select this if people may be exposed to immediate danger or if urgent action is needed to prevent further harm.

Select all controls already put in place, if any. If a control has not been taken, do not select it.

Explain what was done, when it was done and any limitations. If no immediate control was taken, explain why if known.

Select the option that best describes the situation at the time of reporting.

Select the priority based on the reported circumstances and the school’s arrangements. This is not a numerical risk score.

Name the person, team or role responsible for coordinating the response and ensuring the report is followed up.

State the action needed to remove, reduce, isolate or otherwise manage the reported risk. Include any inspection, repair, communication or follow-up needed.

If an action is required, enter the date by which it is intended to be completed. Leave blank only where no action or date has yet been set.

Select all routes that apply under the school’s arrangements.

Record who was notified, when, and any reference or instruction received. Complete this if escalation or notification was made or is required.

If one exists, enter the school, contractor or maintenance reference used to track the action.

Update this field when the response has been reviewed or action has been taken.

Complete this only when the required action has been completed. Leave blank if the action is not complete or no completion date applies.

Enter the name or role of the person who completed the action or updated the status.

Select yes where the completed action needs to be checked to confirm that the reported risk has been addressed or controlled.

If verification has taken place, record who verified it, when, what was checked and the outcome. If verification is pending, state what remains to be checked.

Complete this if the action or control has been verified.

Select this only when the response is complete or the report has been otherwise resolved under the school’s arrangements.

• Tick when complete