Excursion: Private Vehicle Transport
Name of School:
Name of Principal:
Description and Location of excursion:
______
Date(s) of Excursion: / Group/Class: ______Number in Group/Class: ______
Name of Excursion Coordinator:______
Contact Number:
Accompanying staff, parents, volunteers:______
______

OHS RISK MANAGEMENT FORM

Hazard/Risk Identification

(Type/Cause) / Risk
E/M/L /

Current Controls

(Are these still effective? Can they be improved?) / Risk Management Plan - Elimination or Control Measures
(Elimination Substitution Isolation Engineering Administration Personal Protective Equipment)
Risk of injury/illness due to / Priority
Key: / Extreme(E), Moderate(M), Low (L) Risk /

Action Summary - Immediate/Interim Control

/
Who
/
When
  1. Motor Vehicle accident
  1. Child Protection
  1. Entering / exiting car
  2. Other: ______
______
______/ /
  1. Ensure organiser has sighted car registration documentation, driver’s licence comprehensive insurance.
  2. Ensure driver has completed a “Prohibited Declaration Form”.
  3. Brief children on expected behaviour and rules.
  4. Ensure seatbelts are worn.
  5. Walk when entering / exiting the vehicle.
  6. Vehicle to be appropriate (eg wheelchair access etc).
  7. Establish procedures for communicating transport options with parents.
/
  1. Ensure teacher/student ratio is adequate for effective supervision and appropriate positioning of staff.
  2. Ensure seatbelts are available for all passengers.
  3. All volunteers have completed Prohibited Employment Declarations.
  4. Carry First Aid Kit where applicable.
  5. Ensure comprehensive insurance and drivers license are current, sighted by teacher.
  6. Remind students of emergency procedures.
  7. Remind students expected behaviour in cars.
/ Organiser / Before
excursion
On
excursion
Long Term Control
  1. Revise and review Excursion Policy..
  2. Regular updates of training and CPR & Emergency Care.
  3. Revise and review policies relating to Transport by Private vehicle
..
Monitor and Review – Monitor the effectiveness of controls and change if necessary. Review the risk assessment if an incident or significant change occurs.
Plan prepared by: ______Position: ______Date: ______
Prepared in consultation with: DET Policy, PPA Website, Other: ______
Venue and Safety Information and note to parents reviewed and attached: Yes / No / to come Communicated to :