Child/Young Person Risk Assessment
Child’s name: Date of birth: Date form completed: / /
Setting Name Risk Assessor’s Name Date form last updated: / /
Date set for review: / /
HAZARD / RISK / LEVEL OF RISK WITHOUT CONTROL MESURESH/M/L / CONTROL MEASURES / LEVEL OF RISK WITH CONTROL MEASURES
H/M/L / EMERGENCY ACTION TO BE TAKEN
Child will injure themselves/self-harm – uses the floor to head bang when distressed / High (score 7 on risk matrix) / · Proactive measures
o Introduce padded flooring in identified high risk areas
o Increase close adult supervision at key trigger points of the session
o Provide verbal prompts to warn of potential changes of routine that might cause distress
o Introduce ‘real objects’ to support transition / M (score 4 on the risk matrix) / Follow emergency protocol
- Move child to favoured bean bag area
- Put padded cushion under child’s head if prolonged incident
- Padded helmet to be used if incidents continue throughout the session
Comments and any additional information
Level of Risk H = High; M = Medium; L = Low
Risk Assessor:
Sign:…………………………………………………………Print name:……………………….…….…………………………..Date:…………………………
Parent/Carer:
Sign:…………………………………………………………Print name:……………………….…….…………………………..Date:…………………………
Parent/Carer:
Sign:…………………………………………………………Print name:……………………….…….…………………………..Date:…………………………
Manager:
Sign:…………………………………………………………Print name:……………………….…….…………………………..Date:…………………………
Risk Matrix
4 / 5 / 6 / 7 / 83 / 4 / 5 / 6 / 7
2 / 3 / 4 / 5 / 6
1 / 2 / 3 / 4 / 5
0 / 1 / 2 / 3 / 4
Level of risk
Level of Impact
Child/Young Person Risk Assessment
Child’s name: Date of birth: Date form completed: / /
Setting Name Risk Assessor’s Name Date form last updated: / /
Date set for review: / /
HAZARD / RISK / LEVEL OF RISK WITHOUT CONTROL MESURESH/M/L / CONTROL MEASURES / LEVEL OF RISK WITH CONTROL MEASURES
H/M/L / EMERGENCY ACTION TO BE TAKEN
Child will run and hide under a stack of chairs in the hall – risk that the chairs will fall on the child or on the member of staff trying to get him back to the playroom / H (score 7 on the risk matrix) / · Staff to familiarise themselves with triggers and indicators of when this child is more likely to run and hide (namely: transition into the garden and when the setting is particularly busy)
· Provide ear defenders and easy access to a low distraction area designated only for this child
· Staff deployment will include manning the hall door
· Social story will be provided to reinforce the dangers of hiding under chairs
· Restrict access to the hall door using ‘snap fire clasp’
· Ensure all doors are fitted with door alarms
· All staff to become familiar with the setting’s restraint procedures and reporting mechanism / M (score 5 on risk matrix) / · All staff to follow emergency protocol as identified in action plan
· All staff to use agreed restraint protocols
Comments and any additional information
Level of Risk H = High; M = Medium; L = Low
Risk Assessor:
Sign:…………………………………………………………Print name:……………………….…….…………………………..Date:…………………………
Parent/Carer:
Sign:…………………………………………………………Print name:……………………….…….…………………………..Date:…………………………
Parent/Carer:
Sign:…………………………………………………………Print name:……………………….…….…………………………..Date:…………………………
Manager:
Sign:…………………………………………………………Print name:……………………….…….…………………………..Date:…………………………
4 / 5 / 6 / 7 / 83 / 4 / 5 / 6 / 7
2 / 3 / 4 / 5 / 6
1 / 2 / 3 / 4 / 5
0 / 1 / 2 / 3 / 4
Level of
Risk
Level of Impact
Child/Young Person Risk Assessment
Child’s name: Date of birth: Date form completed: / /
Setting Name Risk Assessor’s Name Date form last updated: / /
Date set for review: / /
HAZARD / RISK / LEVEL OF RISK WITHOUT CONTROL MESURESH/M/L / CONTROL MEASURES / LEVEL OF RISK WITH CONTROL MEASURES
H/M/L / EMERGENCY ACTION TO BE TAKEN
When the child becomes very distressed he will throw furniture indiscriminately – risk that the furniture will injure a child or adult in the immediate vicinity or that the child will injure themselves / M (score 5 on the risk matrix) / · All staff to be trained to recognise the warning signs that the child is becoming distressed
· Reduce the amount of hard furniture and replace with soft furniture ( beanbags) or lightweight furniture which would do less damage if hit
· Provide a dark den for child to use when becoming distressed
· Key person to follow behaviour plan and to ensure that all key personal are aware of the plan and how to implement it / L (score 3 on risk matrix) / Follow emergency protocol – adult to remove all children from the immediate vicinity to a safer part of the provision
Comments and any additional information
Level of Risk H = High; M = Medium; L = Low
Risk Assessor:
Sign:…………………………………………………………Print name:……………………….…….…………………………..Date:…………………………
Parent/Carer:
Sign:…………………………………………………………Print name:……………………….…….…………………………..Date:…………………………
Parent/Carer:
Sign:…………………………………………………………Print name:……………………….…….…………………………..Date:…………………………
Manager:
Sign:…………………………………………………………Print name:……………………….…….…………………………..Date:…………………………
Risk matrix
4 / 5 / 6 / 7 / 83 / 4 / 5 / 6 / 7
2 / 3 / 4 / 5 / 6
1 / 2 / 3 / 4 / 5
0 / 1 / 2 / 3 / 4
Level of
Risk
Level on Impact