Sheet 1: Instruction Card

	
	
	
	
	
	
	
	
	
	
	
	
	
	

		
Risk Assessment Failure Mode and Effects Analysis
		
	

		
RA FMEA
		
	

		
Department
		


		


		
FMEA Number
		


		
	

		
Job Title
		


		


		
Date Prepared:
		


		
	

		
Job Task
		


		


		
Date Revised
		


		
	

		
Prepared by
		


		


		
Revision Number
		


		
	

		
Reviewed by
		


		


		
Page 
		


		
of
		


		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
Identification of Ranking of Current Job Title/Task
		


		
Future or Completed Actions
		
Action Results
		
	

		
Process Function & Requirements
		
Potential Hazard or Risk
		
Potential Effects of Failure (Consequences)
		
Potential Cause(s) / Mechanism(s) of Failure
		
Barrier Analysis (Current Risk Controls)
		
SEV
		
EXP
		
BARRIER
		
RPN
		
Recommended Actions
		
Responsibility and Target Completion Date
		
Actions Taken
		
SEV
		
EXP
		
BARRIER
		
RPN
	
	

		


		

 
		
		

 
		
		

 
		
		

 
		
		


		


		


		


	
	

		


		

 
		
		
	

		


		
	

		


		
	

		


		
	

		


		
	

		


		


		


		
	

		


		


		


		
	

		


		


		


		
	

		


		


		


		
	

		


		


		


		
	

		


		


		


		
	

		


		


		


		


		


		


		


		


		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


	

 
 
 
 




Sheet 2: Business Impact

	
	
	
	
	
	
	
	
	
	
	

		
Risk Assessment Failure Mode and Effects Analysis
		
	

		
RA FMEA
		
	

		
Department
		
Business
		


		
FMEA Number
		
1
		
	

		
Job Title
		


		


		
Date Prepared:
		


		
	

		
Job Task
		


		


		
Date Revised
		


		
	

		
Prepared by
		


		


		
Revision Number
		


		
	

		
Reviewed by
		


		


		
Page 
		


		
of
		


		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
Identification of Ranking of Current Job Title/Task
		


		
Future or Completed Actions
		
Action Results
		
	

		
Process Function & Requirements
		
Potential Hazard or Risk
		
Potential Effects of Failure (Consequences)
		
Potential Cause(s) / Mechanism(s) of Failure
		
Barrier Analysis (Current Risk Controls)
		
SEV
		
EXP
		
BARRIER
		
RPN
		
Recommended Actions
		
Responsibility and Target Completion Date
		
Actions Taken
		
SEV
		
EXP
		
BARRIER
		
RPN
	
	

		
Sales
		
Reduction in Sales
		
Loss of revenue
		
Closed businesses don't buy per plan
		
None
		
3
		
1
		
3
		
9
		
Diversify customer base
		
Sales by 5/5/2020
		
Secure contracts with 10 new customers
		
1
		
1
		
3
		
3
	
	

		
Supply Chain Interuption
		
Production interruptions
		
Reduction in available inventory
		
Suppliers are operating with reduced staffing or closed down all together
		
None
		
3
		
1
		
3
		
9
		
Secure multiple suppliers for equipment, chemicals, and maintenance supplies.
		
Purchasing by 5/15/2020
		
Secure 3 additional providers of equipment, 2 providers of chemicals, and one additional maintnencance supply provider.
		
1
		
1
		
2
		
2
	
	

		
Fuel shortages stop trucks
		
None
		
3
		
1
		
4
		
12
		
Maintain reserves of diesel fuel
		
Purchasing by 7/30/2020
		
installed UST system to store and dispense on-road diesel.
		
1
		
1
		
2
		
2
	
	

		
Compliance
		
OSHA Violation
		
Fines and future audits
		
Employee contracts COVID-19 at work
		
None
		
2
		
5
		
4
		
40
		
Train production employees to protect themselves and each other through social distancing, frequent handwashing, and self-monitoring for symptoms.
Provide surface disinfection supplies.
Provide handwashing stations and/or hand sanitizer.
		
Plant manager, or delegate, by 5/8/2020
		
Provided sanitizing supplies, hygiene stations, and training.
		
1
		
1
		
2
		
2
	
	

		
Financial
		
Increased workers comp premiums
		
OSHA recordable illnesses may drive up workers comp premiums
		
Virus spreads person to person easily
		
None
		
2
		
5
		
4
		
40
		
Train production employees to protect themselves and each other through social distancing, frequent handwashing, and self-monitoring for symptoms.
Provide surface disinfection supplies.
Provide handwashing stations and/or hand sanitizer.
		
Plant manager, or delegate, by 5/8/2020
		
Provided sanitizing supplies, hygiene stations, and training.
		
1
		
1
		
2
		
2
	



Sheet 3: Human Impact

	
	
	
	
	
	
	
	
	
	
	

		
Risk Assessment Failure Mode and Effects Analysis
		
	

		
RA FMEA
		
	

		
Department
		
Human Impact
		


		
FMEA Number
		
2
		
	

		
Job Title
		


		


		
Date Prepared:
		


		
	

		
Job Task
		


		


		
Date Revised
		


		
	

		
Prepared by
		


		


		
Revision Number
		


		
	

		
Reviewed by
		


		


		
Page 
		


		
of
		


		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
Identification of Ranking of Current Job Title/Task
		


		
Future or Completed Actions
		
Action Results
		
	

		
Process Function & Requirements
		
Potential Hazard or Risk
		
Potential Effects of Failure (Consequences)
		
Potential Cause(s) / Mechanism(s) of Failure
		
Barrier Analysis (Current Risk Controls)
		
SEV
		
EXP
		
BARRIER
		
RPN
		
Recommended Actions
		
Responsibility and Target Completion Date
		
Actions Taken
		
SEV
		
EXP
		
BARRIER
		
RPN
	
	

		
Logistics
		
Loss of drivers
		
Supply chain interruption
		
Drivers contract COVID-19 or have to take care of a sick family member
		
None
		
2
		
2
		
4
		
16
		
Train drivers to protect themselves and each other through social distancing, frequent handwashing, and self-monitoring for symptoms.
		
H&S Department by 5/5/2020
		
Trained all employees on social distancing, frequent handwashing, and self-monitoring of symptoms
		
1
		
2
		
2
		
4
	
	

		
Production
		
Loss of production employees
		
Production interruption
		
Employee becomes ill
		
None
		
2
		
5
		
4
		
40
		
Train production employees to protect themselves and each other through social distancing, frequent handwashing, and self-monitoring for symptoms.
Provide surface disinfection supplies.
Provide handwashing stations and/or hand sanitizer.
		
Plant manager, or delegate, by 5/8/2020
		
Provided sanitizing supplies, hygiene stations, and training.
		
1
		
1
		
2
		
2
	
	

		
Safety/Health
		
Illness
		
Employee contracts COVID-19 and infects coworkers
		
Virus spreads person to person easily
		
None
		
2
		
5
		
4
		
40
		
Train production employees to protect themselves and each other through social distancing, frequent handwashing, and self-monitoring for symptoms.
Provide surface disinfection supplies.
Provide handwashing stations and/or hand sanitizer.
		
Plant manager, or delegate, by 5/8/2020
		
Provided sanitizing supplies, hygiene stations, and training.
		
1
		
1
		
2
		
2
	
	

		


		
Psychological
		
Absenteeism
		
Employees won't come to work if they are scared of getting sick
		
None
		
2
		
5
		
4
		
40
		
Train production employees to protect themselves and each other through social distancing, frequent handwashing, and self-monitoring for symptoms.
Provide surface disinfection supplies.
Provide handwashing stations and/or hand sanitizer.
		
Plant manager, or delegate, by 5/8/2020
		
Provided sanitizing supplies, hygiene stations, and training.
		
1
		
1
		
2
		
2