Club/Location / Equipment/Activity
Date / Completed by
SECTION A – ACTIVITY LEVEL OF CONTACT RISKS ASSESSMENT
1. Will you have contact with Children and Young People (CYP)? / Yes, then complete questions in 2
  1. Working with Children and Young People Risk Assessment
/ Yes/No
Degree of Isolation / Work involves being alone with CYP
(not frequently enough to be working with CYP) / Yes / No
Work involves activities that are away from the Club / Yes / No
Work involves meeting one-on-one with CYP
(not frequently enough to be working with CYP) / Yes / No
Involves unpredictable or remote settings / Yes / No
Degree of physical contact / Involves demonstrating a skill to CYP / Yes / No
Position involves need for physical contact/touching CYP / Yes / No
Involves providing a personal service (e.g. washing, dressing, toileting) / Yes / No
Degree of supervision / Involves personnel having unsupervised contact with CYP / Yes / No
Activities/engagement with CYP is not observed or monitored / Yes / No
Insufficient number of trained staff to supervise activities/engagement with CYP / Yes / No
Degree of trust / Involves developing close, personal, long term relationships with CYP / Yes / No
Involves online access to CYP personal and/or confidential information / Yes / No
Involves one or more of the following:One-on-one supervision, transporting CYP, overnight supervision, out of town activities, advising or offering guidance to youth or spending extended periods of time with youth e.g. camps / Yes / No
Access to Property / Has access to personal/confidential information / Yes / No
Adult has a perceived or actual level of authority (from CYP perspective) / Yes / No
Skills and knowledge required / Requires specific skills, knowledge, qualifications or service eligibility requirements to undertake a CYP related position / Yes / No
  1. Determine the overall risk associated with the level of contact with CYP

Activity Inherent Risk (tick the box which applies)
LOW / CONTACT / The activity involves or may involve contact with CYP
MODERATE / WORKING / The activity involves working directly with CYP
HIGH / DEGREE OF TRUST / The activity involves working with CYP and involves a high degree of trust (answered yes at least once to above section)
SECTION B - ORGANISATION LEVEL OF CONTACT WITH CHILDREN and YOUNG PEOPLE AND SAFEGUARDING SYSTEMS IN PLACE
Determine whether CLUB or its Partner Agency/Organisation is focused on protection of children and young people and whether safeguarding policies and procedures are in place.
Safeguarding policy and procedures
(A “No” answer to any of these questions indicates a high risk) / Is a Safeguarding Policy in place? / Click here to enter text. /
Recruitment practices, screening completed for all volunteers/staff, before commencing work? / Click here to enter text. /
Notifications/Incident reporting procedures in place? / Click here to enter text. /
Do workers receive safeguarding CYP training? / Click here to enter text. /
Are there adequate boundaries for appropriate behaviour/code of conduct are in place? / Click here to enter text. /
Inadequate or non-existent record keeping (meetings, activities, incidents, reports, logs, record of complaints) / Click here to enter text. /
Prior to engaging them, the organisation checks third party service providers to see if they are a safeguarding CYP organisation / Click here to enter text. /
Determine the inherent risk of CLUB and/or Partner Agency/Organisation.
Organisation Inherent Risk (tick the box which applies)
LOW / NO FOCUS / Organisation is not focused on safeguarding CYP
MODERATE / FOCUS & STRONG SYSTEMS / Organisation is focused on safeguarding CYP and has good safeguarding systems in place
HIGH / FOCUS & POOR SYSTEMS / Organisation is focused on safeguarding CYP and has poor or nil safeguarding systems in place
SECTION C: OVERALL SAFEGUARDING RISK
Determine the overall safeguarding risk from the result of Section A and Section B, using the matrix below.
Organisation Level of Contact with CYP & Systems in Place / Activity Level of Contact with CYP
CONTACT
(LOW) / WORKING
(MEDIUM) / DEGREE OF TRUST
(HIGH)
NO FOCUS
(LOW) / No further assessment required / Complete Safeguarding CYP Risk Matrix / Complete Safeguarding CYP Risk Matrix, Safeguarding Training and take appropriate action
FOCUS & STRONG SYSTEMS
(MODERATE) / Complete Safeguarding CYP Risk Matrix / Complete Safeguarding CYP Risk Matrix / Complete Safeguarding CYP Risk Matrix, Safeguarding Training and take appropriate action
FOCUS & POOR SYSTEMS
(HIGH) / Complete Safeguarding CYP Risk Matrix and take appropriate actions / Complete Safeguarding CYP Risk Matrix, Safeguarding Training and take appropriate action / High Risk determine whether to proceed with activity

Life Saving Victoria – Safeguarding Children and Young People Page 1 of 3 December2016 V1.0