Citibase Monthly H&S Centre checks DRAFT

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

M1 Emergency Lighting Check

• Has the emergency lighting been tested to ensure it works?

  Yes

  No

  N/A

• Have the results been recorded in the Fire Log book?

  Yes

  No

  N/A

• Were any failures present?

  Yes

  No

  N/A

• Has the sheet been scanned and uploaded to the Cloud?

  Yes

  No

  N/A

M2 Tenant Fire Marshall list

• Is the tenant Fire Marshall list up to date?

  Yes

  No

  N/A

• Has the sheet been scanned and uploaded to the Cloud?

  Yes

  No

  N/A

M3 Fire Door Condition

• Do the doors self close and shut tight?

  Yes

  No

  N/A

• Is the door closer fixed to the door and frame securely?

  Yes

  No

  N/A

• Are door handles affixed securely? In the event of an emergency, can the door be opened without a key?

  Yes

  No

  N/A

• Are any seals (if present) in good condition?

  Yes

  No

  N/A

• Is the door glazing secure and unbroken? Does the glazing provide a clear and unobstructed view from both sides of the door?

  Yes

  No

  N/A

• Are the doors hinges secure?

  Yes

  No

  N/A

M4 Excess furniture store

• Is all excess furniture stored securely to avoid falls?

  Yes

  No

  N/A

• Is any excess furniture logged?

  Yes

  No

  N/A

M5 First Aid kit

• Has the contents of the First Aid Kit been checked and replenished as necessary?

  Yes

  No

  N/A

• Are all contents in date?

  Yes

  No

  N/A

M6 Legionella checks

• Have all taps in our demise been temperature tested?

  Yes

  No

  N/A

• Were all recorded temperatures within the permitted range (lower than 20 degrees Celsius for cold, above 45 degrees Celsius for hot). If not, state any action taken

  Yes

  No

  N/A

• Has the sheet been scanned and uploaded to the Cloud?

  Yes

  No

  N/A

• Centre Manager

  Sign