PF057.0 Exceedances Risk Assessment Form PF057.0 Exceedances Risk Assessment Form In accordance with the company’s policy on working hours we are required to carry out a risk assessment for any excessive hours that need to be worked. The recognised limits on working hours are as follows: – Work shifts of more than 12 hours on site (or 14 hours including travel to/from site) Work more than 60 hours per week (consecutive shifts) Work more than 13 shifts in 14 days Have less than 12-hour rest periods between consecutive shifts If required to exceed limits on working hours the relevant senior line manager must be consulted and this form must be used to assess any additional risk posed. Go to top RISK ASSESSMENT IS THIS AN EMERGENCY? * YESNO COMMENTS * ARE THE WORKS SAFETY CRITICAL? * YESNO COMMENTS * CAN THE WORK BE CARRIED OUT AT ANOTHER TIME? * YESNO COMMENTS * HAVE HOURS WORKED ON SITE ALREADY EXCEEDED 12? * YESNO HOURS WORKED * DOES THE TYPE OF WORK CAUSE EXTRA FATIGUE? * YESNO COMMENTS * IS TRAVELLING TO / FROM SITE A FACTOR? * YESNO (WHAT DISTANCE? - HOW LONG? - WILL THE TOTAL SHIFT incl. TRAVEL TIME EXCEED 14 HOURS?) * DO STAFF KNOW HOW MANY EXTRA HOURS ARE NEEDED TO COMPLETE THE SHIFT? * YESNO COMMENTS * DID STAFF HAVE ADEQUATE REST BEFORE THE SHIFT? * YESNO COMMENTS * DID STAFF WORK ANY EXCESS HOURS IN THE PREVIOUS WEEK?(Including work for other employers?) * YESNO COMMENTS * HAVE STAFF HAD BREAKS / MEALS? * YESNO COMMENTS * IF APPROPRIATE , ARE ADDITIONAL STAFF AVAILABLE TO RELIEVE / ATTEND SITE? * YESNO COMMENTS * IS THE PROVISION OF A DRIVER APPROPRIATE? * YESNO COMMENTS * ARE EXTENDED REST PERIODS REQUIRED PRIOR TO WORKING THE NEXT SHIFT? * YESNO COMMENTS * ARE ADDITIONAL BREAKS REQUIRED? * YESNO COMMENTS * IS A HOTEL STAY APPROPRIATE? * YESNO COMMENTS * PERSON REQUESTING RISK ASSESSMENT NAME OF PERSON REQUESTING THE RISK ASSESSMENT * NAME OF PERSON REQUESTING THE RISK ASSESSMENT First First Last Last SITE LOCATION * CLIENT * LINE MANAGER COMPLETING RISK ASSESSMENT NAME OF LINE MANAGER COMPLETING THE RISK ASSESSMENT * NAME OF LINE MANAGER COMPLETING THE RISK ASSESSMENT First First Last Last DECISION * APPROVEDDECLINED REASON FOR DECISION * Date * Time of Assessment 000102030405060708091011121314151617181920212223 : 001020304050 Assessor Signature * signature keyboard Clear If you are human, leave this field blank. Submit
