ࡱ>  bjbjll Mj1gj1g 0008hT0/&^.......$1\4 /" / /$>!>!>!.>!.>!>!)*,)*./</7*4l 4*4*>! / /x/4 X :  Template Risk-based Assessment Sheet For External Curriculum-based Placement & Extra-ECTS Placements The sheet can be used to log issues (their consideration and resolution) throughout the pre-departure period and throughout the placement. Please aim to involve the student(s). The objective in all discussion of risk is to draw conclusions as to whether outstanding risks, with any control measures which can be reasonably put in place, are tolerable from the perspective of the College and the student(s). It is important not to confuse risk with hazard. Hazard is something with the potential to cause harm, while risk is the severity and likelihood of harm occurring. Student and Placement DetailsStudent or Student Group NumberSurnameFirst nameCIDDate added123Name of Placement ProviderLocationHas a completed HYPERLINK "http://www.imperial.ac.uk/about/governance/academic-governance/academic-policy/placement-learning/"Placement Provider Information Form been received from the Organisation for this particular placement(s) or is there a valid student exchange agreement?Placement Provider Information FormStudent Exchange AgreementRisk-based assessment, indicating further specific actions necessary For further guidance on the factors influencing the risk profile see HYPERLINK "/placements/information-for-imperial-college-staff/"Registry Website The risk profile does not have to be low across the board for a placement to be approved. The Department should assess all risks, pursue follow-up actions and come to a judgment as to whether any medium or high risk can be tolerated. Aim to involve the student as necessary. Please note: Details of certain elements of a placement are not always known in advance of departure to the host organisation. For example, an internship undertaken as part of a Year Abroad at a university is not normally arranged until after arrival at the host university. Equally such internships may or may not be managed by the host university and may require separate approval as a placement in their own right by the home department. Circumstances upon arrival or during a placement can change, quite significantly sometimes, including changes to location, research topic, working environment. A template HYPERLINK "http://www.imperial.ac.uk/about/governance/academic-governance/academic-policy/placement-learning/"Student Placement Approval Form is available for formally approving a placement. Risk FactorsRisk profile (high, medium or low)Action necessary? Control measures required. This may require following College Off-Site Working Procedures  HYPERLINK "/placements/information-for-imperial-college-staff/" /placements/information-for-imperial-college-staff/ Action completed?Academic (degree programme) factors For further guidance on the following factors influencing the risk profile see HYPERLINK "/placements/information-for-imperial-college-staff/"Registry Website There may be factors which influence each other.Work Factors e.g. will the work involve hazardous substances (i.e. chemicals, infectious agents), use of ionising radiation, manual handling, entering laboratories, workshops, using machinery or research equipment, working aloneTravel and transportation factors e.g. levels of travel during placement, including commuting; risky local transport facilities, does the placement itself involve using vehicles Location and/or regional factors e.g. How does the FCO rate a location (in terms of risk)? Availability of services, like emergency services.  General/environmental health factors e.g. climate; infectious diseases  Individual student factors e.g. health, disability, linguistic ability, cultural awareness Insurance limitations If in any doubt consult the Colleges Insurance Manager  Details of any Preparatory Site Visit: (date; location if different to that noted above; name of staff member making the visit; name of staff visited; notes on topics discussed and outcomes; any follow-up action and outcomes) Text box for additional notes: Form Completed by : Role Registry/June 2014     *+/3Ujlmz      ˹~ii^hQhB6CJaJ)hQhB6CJ^JaJfHq hQhqCJ^JaJhB6CJ^JaJhQh/CJ^JaJhQhB6CJ^JaJh/CJ^JaJhCJaJ h@5 hn5 hB65h_h/5h0:h/5h/5CJaJ h/5!jh/5UmHnHsH u!+lm  p/$d%d&d'd-DM NOPQgdq/$d%d&d'd-DM NOPQgdQgdqB&$d%d&d'dNOPQgd/gd/  QHHHH $IfgdP4xkd$$Ifl`''  t 0'44 lap yt< $Ifgd1gdqB&$d%d&d'dNOPQgd/                     ! 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