Title Page
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Location & Report Name
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Client
- Shal
- Abri
- Alliance Homes
- Cornwall Housing
- Dartford BC
- Exeter City Council
- Live West
- Stroud
- Other
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Date
General Details
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Risk Assesment Completed By
- David Fox
- Jeremy Illy
- Sean Glossop
- Steve Britton
- Vinnie Stokes
- Mark McArdle
- Lee Glenister
- Neil Roberts
- Steve Tap
- David Da Boo
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Site Address
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Date of Inspection
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Residents Name
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Residents contact details
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Residents email address
Decarbonisation Funding Privacy Consent Information
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To enable the administration of the above Client, Low carbon Exchange required to process personal information relating to you and your home. Your information will be shared with your housing association, your installer, and the Department for Business, Energy and Industrial Strategy (BEIS) who are funding the installations as part of the Local Authority Delivery Scheme. Data processing will only be carried out for the purpose of delivery, administration and evaluation of this scheme as well as statistical, research and fraud prevention purposes. The eligibility for funding may rely on persons within household being in receipt of one or more benefits, It is expected that processing will include linking of your personal data to other datasets and, may involve contacting you to ask if you would like to participate in further research and evaluation activities
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Do you consent to being recontacted by your local authority/housing association, BEIS, or their appointed contractors, for the purpose of research and evaluation related to the installation received under Energy Efficiency Project.
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Can you confirm that the household is in receipt of one or more benefits? For example state pension or child support?
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Can you confirm that the households total income does not exceed £30,000 per year?
COVID 19 Assessment
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Have you or anyone that lives at the property been diagnosed with Coronavirus ?
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Is anyone at the property currently self-isolating ? or shielding ? (in the vulnerable category)
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Have you or anyone who lives at the property had any flu like symptoms at all in the last 7 days ?
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Can you think of any reason why we shouldn't visit your home ?
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Comments
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Do you give consent for us to carry out works within your property ?
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Reasoning?
Access Assessment
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Does the property have suitable access for the proposed works to be carried out safely ?
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Comments
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Photographic evidence
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Does the property have suitable access for the transportation of materials and equipment ?
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Comments
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Photographic evidence
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Are there any restrictions to the property i.e. Low bridge, neighbours access required ?
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Comments
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Photographic evidence
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Is the property location a main pedestrian route and/or a public walkway ?
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Comments
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Photographic evidence
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Is parking available, adequate for the size of vehicle and close to the property ?
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Comments,
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Photographic evidence
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Do parking restrictions exist i.e. Residents parking ?
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Comments
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Photographic evidence
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Will the proposed works affect neighbouring properties ?
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Comments
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Photographic evidence
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Has the neighbouring property been notified of the immanent works?
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Date of notification given-
Occupant Assessment
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Is the property in a suitable condition for the proposed works to be carried out ?
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Comments
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Photographic evidence
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Is the property highlighted as flagged or at risk ?
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Comments
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Do the occupants have any physical disabilities that pose any significant risks ?
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Comments
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Do the occupants have any learning difficulties where our activities may pose any significant risks ?
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Comments
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Are there any potential risks regarding minors in the property ?
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Comments
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Are there any potential risks regarding pets in the property ?
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Comments
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Is the property high risk of biological waste or vermin ?
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Comments
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Photographic evidence
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Is the property at high risk of hypodermic needles ?
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Comments
Services Assessment
Dust Ingress Points
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Please take photos of potential dust ingress hotspots
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Please state where these points are
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Are there any overhead power lines that could pose a potential risk ?
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Comments
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Photographic evidence
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Are there any telephone lines or brackets fixed to the external walls that could pose a potential risk ?
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Comments
- BT Lines
- Wall Brackets
- Sky Dishes
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Photographic evidence
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Are there any electrical cables fixed to the external walls that could pose a potential risk ?
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Comments
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Photographic evidence
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Are there any gas supply pipes fixed to the external walls that could pose a potential risk ?
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Comments
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Photographic evidence
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Are there any electric or gas meter cupboards fixed to external walls that could pose a potential risk ?
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Comments
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Photographic evidence
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Does the property have a gas flue that could pose a potential risk ?
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Comments
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Photographic evidence
Asbestos Assessment
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Are we in receipt of or have access to the asbestos survey or register for this property ?
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Comments
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Has asbestos been identified ?
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Comments
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Photographic evidence
Assessment Sign off
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Surveyors Signature and Full name
