Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

External Areas

  • If you were to walk around the outside of Maccabi House, do you find or spot any near misses that needs to raised?

  • Did you spot any near misses in the court yard

  • Did you spot any near misses in the shared fire evacuation route (outside of Maccabi House)

  • Is the pedestian gate operate

  • Is the vehicle gate operate

Public Toilets

  • Please check the public toilets and assess if reasonably safe to use

  • Did you spot any obvious near misses in the Gent toilets?

  • Are taps working as they should?

  • Did you spot any obvious near misses in the Ladies' toilets?

  • Are taps working as they should?

  • Did you spot any obvious near misses in the Disabled toilets?

  • Are taps working as they should?

Communal Areas

  • Please check the communal areas and assess if reasonably safe to access

  • Did you spot any near misses at the entrance areas to the flats and offices?

  • Did you spot any near misses in the main hall?

  • Did you spot any near misses in the back room?

  • Did you spot any near misses in the storage room?

  • Did you spot any near misses in the IT server room?

  • Did you spot any near misses in the 121 room?

Fire Doors

  • You are required to visually assessing the fire doors throughout the centre

  • Did you find any fire doors left open in the main hall? (please close if this is the case)

  • Did you find any fire doors left open in the back room? (please close if this is the case)

  • Did you find any fire doors left open in the main storage room? (please close if this is the case)

  • Did you find any fire doors left open in the office area? (please close if this is the case)

  • Are fire doors restricted in any way? (For example, boxes or items in front of the door, or behind)... where?

IT (Server Room)

  • Visually take a look and ensure no obvious risks are visible

  • Anything to report?

  • Please detail and (take photos)

Lights

  • Across the site, please check all lights are operational if not, please report via MaintainX

Kitchen Area

  • Did you spot any lights not working?

Main Hall

  • Did you spot any lights not working?

Back Room

  • Did you spot any lights not working?

Storage Room

  • Did you spot any lights not working?

Toilets

  • Did you spot any lights not working?

IT Server Room

  • Did you spot any lights not working?

External Route

  • Did you spot any lights not working? (if applicable)

Fire Extinguishers

  • Are all fire extinguisher in their normal place

  • Are fire extinguishers in their correct locations (mainly here a fire escape route)?

  • Are the blue/green taps in place and untouched?

Fire Panel

  • Check the status of the fire panel

  • Are there any faults on the display panel?

Air Con Units

  • Check if all air con units are operational (if applicable)

  • Are units working as per normal?

Slip, Trip or Falls

  • Did you spot any slip, trip or falls within the main hall?

  • Did you spot any slip, trip or falls within the office area?

  • Did you spot any slip, trip or falls within the back office?

  • Did you spot any slip, trip or falls within the communal areas?

  • Did you spot any slip, trip or falls within the toilet areas?

  • Did you spot any slip, trip or falls within the main storage area?

  • Did you spot any slip, trip or falls within the court yard?

  • Did you spot any slip, trip or falls within the external fire escape routes?

  • Take as many photos of possible of any obvious near misses if "answered" yes!

Sign off

  • Full Name

  • Date

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