Title Page

  • Date of Scene Investigation

  • Name of Investigator

  • Location

Incident Number

Date & Time of Fire

Address of Fire

Risk Assessment

  • Detail hazards and control measures

Contact Information

  • Contacts

Arson Checklist

  • Signs of Forced Entry?

  • Multiple Seats of Fire?

  • Presence of an Accelerant?

  • Covered External windows?

  • Internal Doors Wedged Open?

  • Is the Fire in an Unusual Location?

  • Is the Fire Considered to be Deliberate?

  • Provide further details as required

Indicators

  • Location Where the Fire Occurred (Description)

  • Evidence from Glass Damage? (Description)

  • Burn Patterns to Walls? (Description)

  • Burn Patterns to the Floor? (Description)

  • Burn Pattern to the Ceiling? (Description)

  • Directional Burning? (Description)

  • Smoke Damage (Description)

  • Is Gas Involved?

  • Provide details

  • Is Electricity Involved?

  • Provide details

  • Were Combustible Materials too Close to ignition source?

  • Were Ventilation/Flues Satisfactory?

  • Is There Evidence of Faulty Controls

  • Is There a History of Faults or Problems

  • Is There Evidence of Misuse of Equipment/Appliances

Naked Flames

  • Candles, Lighter, Matches, Other

  • Provide details

Cooking

  • Is Cooking Involved?

  • Provide details

Smoking

  • Smoking Policy in Operation?

  • Ashtrays and Waste Bins Emptied?

  • Anyone Smoking Prior to the Fire?

  • Evidence of Previous Burn Marks Due to Smoking?

  • Previous Carelessly Discarded Cigarettes?

  • Provide further information if required?

Conclusion

  • Point of Origin?

  • Source of Ignition?

  • What was the Item First Ignited?

  • Hypotheses (What Were the Circumstances, Defects, Actions or Omissions that Brought the Fire about?)

  • Further Investigation Information if Required

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.