Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
Entrance
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Locks working/thumb lock
- Yes
- No
- N/A
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Condition of walls Floors and Ceiling
Living room/Dining room
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Condition Ceiling/walls + floors
- Good
- Fair
- Poor
- N/A
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Windows/restrictors
- Yes
- No
- N/A
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Electric fixtures
- Clean
- Safe
- Damaged
- N/A
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Radiator working
Kitchen
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Ceiling/walls + floors
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Windows/restrictors
- Yes
- No
- N/A
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oven hood working
- Pass
- Fail
- N/A
-
Appliances
- Clean
- Safe
- Damaged
- N/A
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radiator working
- Yes
- No
- N/A
Hall way/landing
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Hall way
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Condition Celling walls & Floors
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Smoke alarm /
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Lighting
Bedroom 1
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Ceiling/walls + floors
- Clean
- Safe
- Damaged
- N/A
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Windows/restrictors
- Yes
- No
- N/A
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Smoke alarm
- Pass
- Fail
- N/A
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radiator working
- Yes
- No
- N/A
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Bedroom 2
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Ceiling/walls + floors
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Smoke alarm
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Radiator working?
Bathroom
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Ceiling/walls + floors
- Clean
- Safe
- Damaged
- N/A
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Windows/restrictors
- Yes
- No
- N/A
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Radiator working
- Clean
- Safe
- Damaged
- N/A
Safety
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Smoke alarm
- Pass
- Fail
- N/A
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fire blanket
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fire extinguisher
- Pass
- Fail
- N/A
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Gas Boiler
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date of last Service
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Carbon monoxide Alarm
- Pass
- Fail
- N/A
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Vents unblocked
- Yes
- No
- N/A
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Rubbish/Hoarding
- Yes
- No
- N/A
General
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Trip switches
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Type of heating system
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Location of gas shut off
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Location of water shut off
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MPRN
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GPRN
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Management Company
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Fire panel location
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Key box location + code
Comments
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Comments
