2023 Risk Assessment Survey

The purpose of this survey is to help your Health & Safety Committee to complete an organization-wide Risk Assessment. The Risk Assessment is required by WorkSafeBC and is for risks that impact staff in their work, not risks to the public. The goal is to identify hazards that impact staff health and safety, determine their level of risk, and develop strategies to reduce the risks identified.

The first step in the Risk Assessment process is to identify all the hazards that staff face in their workplace. A hazard is defined as anything you encounter in the course of your work that can harm or adversely affect you (for example: tripping on the stairs, wrist strain from shelving books, or emotional/mental distress from a patron's verbal abuse). 

All staff members are required to participate in the survey. Please list as many hazards as you can (up to 20), but please include at least 5. Your personal information will not be shared when the data is compiled, but your name and email are necessary to to ensure that you have completed the survey as required. If you have any questions please contact a member of the Leadership Team or your Health & Safety Committee representative.

Personal Information
Workplace Hazards
Identify and describe the hazards you face in your workplace on a daily basis. A hazard is defined as anything you encounter in the course of your work that can harm or adversely affect you.
Hazard #1
Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #6
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #7
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #8
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #9
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #16
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #19
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #18
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #17
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #11
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #15
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #14
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #13
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #12
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #10
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *
Hazard #20
Name of Hazard:
Other Category:
12345
Indicate the level of concern this hazard represents in your workplace (1=Highest Concern 5=Lowest Concern): *
HighModerateLow
Rate this hazard for its potential for serious injury or harm to yourself or other staff members: *