CTC - H&S 2015

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Left Vestibule

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• Are the fire sensors in order on the door exits and roof?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Doors

• Are the doors operating to safe standards? Eg opening and locking properly.

  Safe

  At Risk

  N/A

Auditorium

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the chairs safe for purpose?

  Safe

  At Risk

  N/A

• Yes

  No

  N/A

• Is the under stair cupboard safely packed and stacked?

  Yes

  No

  N/A

• Are the chairs safely stacked no higher than 6 chairs?

  Safe

  At Risk

  N/A

• Are all stairs, ladders and railings safe and fit for purpose?

  Safe

  At Risk

  N/A

Camera

• Stage Left - Are there trip hazards around the camera tripods legs?

  Safe

  At Risk

  N/A

• Stage Right - Are there trip hazards around the camera tripods legs?

  Safe

  At Risk

  N/A

• Are the cables safe?

  Safe

  At Risk

  N/A

• Have the cables been left in a safe manner?

  Safe

  At Risk

  N/A

Electrical Safety

• Are all safety lights on the stairs working?

  Yes

  No

  N/A

• Are the electrical cupboards clear of obstructions?

  Yes

  No

  N/A

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• Stage Left - CO2 - Are fire extinguishers in place & signed?

  Yes

  No

  N/A

• Are fire extinguishers within service dates?

  Yes

  No

  N/A

• Are all fire/emergency exit signs in place?

  Yes

  No

  N/A

• Are exits clear of obstructions?

  Yes

  No

  N/A

• Does fire equipment appear to be in good condition?

  Yes

  No

  N/A

• Stage Right - CO2 - Are fire extinguishers in place & signed?

  Yes

  No

  N/A

• Auditorium Back - CO2 - Are fire extinguishers in place & signed?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Stage

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Sound/TV/AV Back of auditorium

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Server Room

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• Are the fire sensors in order on the door exits and roof?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Doors

• Are the doors operating to safe standards? Eg opening and locking properly.

  Safe

  At Risk

  N/A

Right Vestibule

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• Are the fire sensors in order on the door exits and roof?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Doors

• Are the doors operating to safe standards? Eg opening and locking properly.

  Safe

  At Risk

  N/A

Overflow Area

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are all cupboard packed safely?

  Safe

  At Risk

  N/A

• Are the chairs safely stacked no higher than 6 chairs?

  Safe

  At Risk

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• Are fire extinguishers in place & signed?

  Yes

  No

  N/A

• Are fire extinguishers within service dates?

  Yes

  No

  N/A

• Are all fire/emergency exit signs in place?

  Yes

  No

  N/A

• Are exits clear of obstructions?

  Yes

  No

  N/A

• Does fire equipment appear to be in good condition?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fellowsip Area/Kitchen

House Keeping

• Is the sink area clean and safe?

  Safe

  At Risk

  N/A

• Are the fridges and freezers fit for purpose?

  Yes

  No

  N/A

• Are the fridges and freezers clean and tidy free of decaying foods?

  Yes

  No

  N/A

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are all draws, cupboards including cupboard next to disabled toilet packed safely and clean?

  Yes

  No

  N/A

• Are bench tops clean and tidy?

  Yes

  No

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the chairs safely stacked no higher than 6 chairs?

  Safe

  At Risk

  N/A

Electrical Safety

• Are the electrical cupboards clear of obstructions inside and out?

  Safe

  At Risk

  N/A

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• CO2 and Water - Are fire extinguishers in place & signed?

  Yes

  No

  N/A

• Are fire extinguishers within service dates?

  Yes

  No

  N/A

• Are all fire/emergency exit signs in place?

  Yes

  No

  N/A

• Are exits clear of obstructions?

  Yes

  No

  N/A

• Does fire equipment appear to be in good condition?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Conservatory

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the chairs safely stacked no higher than 6 chairs?

  Safe

  At Risk

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• CO2 and Water - Are fire extinguishers in place & signed?

  Yes

  No

  N/A

• Are fire extinguishers within service dates?

  Yes

  No

  N/A

• Are all fire/emergency exit signs in place?

  Yes

  No

  N/A

• Are exits clear of obstructions?

  Yes

  No

  N/A

• Does fire equipment appear to be in good condition?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Crib - Crèche

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the chairs safely stacked no higher than 6 chairs?

  Safe

  At Risk

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Female Toilets

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

Electrical Safety

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Male Toilets

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

Electrical Safety

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Disabled Toilets

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

Electrical Safety

• Are there any broken plugs or outlets?

  Yes

  No

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Studio

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the cupboards safely packed?

  Safe

  At Risk

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• Are all fire/emergency exit signs in place?

  Yes

  No

  N/A

• Are exits clear of obstructions?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Upstairs Switch/Server Room

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the cupboards safely packed?

  Safe

  At Risk

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• Are all fire/emergency exit signs in place?

  Yes

  No

  N/A

• Are exits clear of obstructions?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Boiler Room

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• Are exits clear of obstructions?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

KidZone

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the chairs safely stacked no higher than 6 chairs?

  Safe

  At Risk

  N/A

• Are the cupboards safely packed?

  Safe

  At Risk

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• Are all fire/emergency exit signs in place?

  Yes

  No

  N/A

• Are exits clear of obstructions?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Upstairs Kitchen Area

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the cupboards safely packed?

  Safe

  At Risk

  N/A

• Is the fridge clean, tidy, no food food decaying needing to be thrown out?

  Yes

  No

  N/A

• Is the microwave clean and safe?

  Safe

  At Risk

  N/A

• Are the refuse bins clean, tidy, no food hanging out of the bin or on the floor?

  Yes

  No

  N/A

• Is the sink area clean and tidy?

  Yes

  No

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• CO2 - Are fire extinguishers in place & signed?

  Yes

  No

  N/A

• Water - Are fire extinguishers in place & signed?

  Yes

  No

  N/A

• Are fire extinguishers within service dates?

  Yes

  No

  N/A

• Are all fire/emergency exit signs in place?

  Yes

  No

  N/A

• Are exits clear of obstructions?

  Yes

  No

  N/A

• Does fire equipment appear to be in good condition?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Upstairs Toilet

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the cupboards and draws safely packed?

  Safe

  At Risk

  N/A

• Is the sink area clean and tidy?

  Yes

  No

  N/A

• Are there enough paper towels and toilet roles?

  Yes

  No

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Pastors Fellowship Area

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the chairs safely stacked no higher than 6 chairs?

  Safe

  At Risk

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• CO2 - Are fire extinguishers in place & signed?

  Yes

  No

  N/A

• Water - Are fire extinguishers in place & signed?

  Yes

  No

  N/A

• Are fire extinguishers within service dates?

  Yes

  No

  N/A

• Are all fire/emergency exit signs in place?

  Yes

  No

  N/A

• Are exits clear of obstructions?

  Yes

  No

  N/A

• Does fire equipment appear to be in good condition?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Room 1 - Accounts

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the cupboards and filling cabinets packed safely?

  Safe

  At Risk

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Lift Area

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Yes

  No

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Room 2 - Pastors Office

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Is there enough paper towels and toilet roles in the toilet?

  Yes

  No

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Room 3 - Counselling Room

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Room 4 - Neil and Trish Office

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the cupboards and filling cabinets packed safely?

  Safe

  At Risk

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Upstairs Auditorium - Left

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the chairs safely stacked no higher than 6 chairs?

  Safe

  At Risk

  N/A

Electrical Safety

• Are the electrical cupboards unobstructed inside and out?

  Safe

  At Risk

  N/A

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• Water - Are fire extinguishers in place & signed?

  Yes

  No

  N/A

• Are fire extinguishers within service dates?

  Yes

  No

  N/A

• Are all fire/emergency exit signs in place?

  Yes

  No

  N/A

• Are exits clear of obstructions?

  Yes

  No

  N/A

• Does fire equipment appear to be in good condition?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Upstairs Auditorium - Right

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the chairs safely stacked no higher than 6 chairs?

  Safe

  At Risk

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Back Stair and Fire Exit

House Keeping

• Are there any visible trip or slip hazards?

  Safe

  At Risk

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Is the floor area clean of rubbish?

  Yes

  No

  N/A

• Are the stairs and railings fit for safe use?

  Safe

  At Risk

  N/A

Electrical Safety

• Are there any cables creating a hazard?

  Safe

  At Risk

  N/A

• Are there any broken plugs or outlets?

  Safe

  At Risk

  N/A

• Have all electrical items been PAT tested.

  Yes

  No

  N/A - Not Required

• Is there evidence of up to date PAT on electrical items?

  Yes

  No

  N/A - Not Required

• Is PAT testing up to date?

  Yes

  No

  N/A - Not Required

• Are there multiple double adaptors in a series?

  Safe

  At Risk

  N/A

• Are there signs of overloading of power boards, power points?

  Safe

  At Risk

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Fire

• Water - Are fire extinguishers in place & signed?

  Yes

  No

  N/A

• Are fire extinguishers within service dates?

  Yes

  No

  N/A

• Are all fire/emergency exit signs in place?

  Yes

  No

  N/A

• Are exits clear of obstructions?

  Yes

  No

  N/A

• Does fire equipment appear to be in good condition?

  Yes

  No

  N/A

• Photograph of any issues.

  Media

• What other observations can you make?

• What actions are required to rectify these issues.

Outside Parking Area and Gardens

• Do all security lights work according to manufacturer and safety standards?

  Yes

  No

  N/A

• Are all entry and exit points free from obstruction.

  Yes

  No

  N/A

• Are there any broken or damaged windows?

  Yes

  No

  N/A

• Are emergency assembly points clearly defined.

  Yes

  No

  N/A

• Is the garden area clean and safe free from all rubbish?

  Yes

  No

  N/A

• Is the area safe?

  Safe

  At Risk

  N/A

• Are disabled parking spaces clearly defined?

  Yes

  No

  N/A

• Are vehicle spaces clearly marked?

  Yes

  No

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Are the bins full and overflowing?

  Yes

  No

  N/A

• What other observations can you make?

• What actions are required to rectify these issues.

Rubbish Storage Area

• Is the area safe?

  Safe

  At Risk

  N/A

• Are there signs of rat and or mouse infestations?

  Yes

  No

  N/A

• Are there any obstructions?

  Safe

  At Risk

  N/A

• Are the bins full and overflowing?

  Yes

  No

  N/A

• What other observations can you make?

• What actions are required to rectify these issues.

Signature and date

• Please type your full name.

• Please sign

  Sign

• Please set today's date and the time.

  Date