Activity Based Risk Assessment Form Mom Template for Australia

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Key Requirements PROMPT example:

Activity Based Risk Assessment Form Mom

"I need an Activity Based Risk Assessment Form Mom for a laboratory technician returning from maternity leave in March 2025, with specific focus on chemical exposure risks and ergonomic considerations for a research facility in Melbourne."

Document background
The Activity Based Risk Assessment Form Mom is a crucial workplace safety document required under Australian health and safety legislation to protect pregnant employees and new mothers in the workplace. This form should be completed when an employee notifies their pregnancy, returns from maternity leave, or when their work circumstances change. It incorporates comprehensive risk evaluation methodology aligned with the Work Health and Safety Act 2011 (Cth) and state-specific regulations, ensuring that all potential hazards are identified and appropriate control measures are implemented. The assessment considers various factors including physical demands, workplace environment, ergonomic requirements, and specific job-related risks, while also accounting for different stages of pregnancy and post-partum needs. Regular reviews and updates are required to ensure continued effectiveness of control measures and compliance with safety standards.
Suggested Sections

1. Assessment Details: Basic information including date, location, assessor name, and mother's details

2. Activity Description: Detailed description of the work activities being assessed

3. Current Stage: Identification of pregnancy stage or post-partum status to determine specific risk factors

4. Hazard Identification: Systematic listing of potential hazards associated with the activities

5. Risk Assessment Matrix: Standard risk matrix showing likelihood and consequence ratings

6. Initial Risk Rating: Assessment of risks before control measures are implemented

7. Control Measures: Specific measures to eliminate or minimize identified risks

8. Residual Risk Rating: Assessment of remaining risks after control measures are implemented

9. Monitoring Requirements: Schedule and methods for ongoing monitoring of implemented controls

10. Review and Sign-off: Approval section including signatures from assessor, mother, and supervisor

Optional Sections

1. Medical Considerations: Section for specific medical conditions or requirements, to be included when there are special medical circumstances

2. Ergonomic Assessment: Detailed ergonomic evaluation, to be included for desk-based or repetitive physical tasks

3. Temperature and Environmental Conditions: Assessment of workplace environment, to be included for outdoor work or temperature-sensitive environments

4. Chemical Exposure Assessment: Detailed assessment of chemical risks, to be included when work involves potential exposure to hazardous substances

5. Emergency Response Procedures: Specific emergency procedures, to be included for high-risk work environments

6. Breastfeeding Facilities Assessment: Evaluation of facilities and breaks needed, to be included for nursing mothers

Suggested Schedules

1. Appendix A: Risk Matrix Guide: Detailed guide for using the risk assessment matrix

2. Appendix B: Hazard Checklist: Comprehensive checklist of potential hazards specific to pregnant and nursing mothers

3. Appendix C: Control Measures Library: Reference list of standard control measures for common risks

4. Appendix D: Relevant Legislation: Summary of applicable workplace health and safety legislation

5. Appendix E: Emergency Contacts: List of relevant emergency and medical contacts

6. Schedule 1: Review Timeline: Schedule for periodic reviews and updates of the risk assessment

7. Schedule 2: Monitoring Checklist: Checklist for regular monitoring of control measures

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions
Relevant Industries

Healthcare

Education

Professional Services

Retail

Manufacturing

Hospitality

Government and Public Sector

Construction

Mining

Information Technology

Financial Services

Transport and Logistics

Agriculture

Scientific Research

Media and Communications

Relevant Teams

Human Resources

Workplace Health and Safety

Occupational Health

Risk Management

Operations

Facilities Management

Legal and Compliance

Industrial Relations

Employee Relations

Medical Services

Relevant Roles

Workplace Health and Safety Manager

Human Resources Director

Occupational Health Nurse

Risk Assessment Specialist

Health and Safety Coordinator

HR Business Partner

Operations Manager

Facility Manager

Department Supervisor

Safety Compliance Officer

Employee Relations Manager

Occupational Health and Safety Consultant

Return to Work Coordinator

Industrial Relations Manager

Industries
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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