Information

  • Client / Site

  • Conducted on

  • Prepared by

  • Photo of site

  • PART 1 GENRAL INFORMATION

  • Name of responsible person

  • Contact details of responsible person

1 The Building

  • Number of floors

  • Brief details of construction

  • Occupancy type

2 The Occupants

  • Maximum number of occupants

  • Maximum number of members of the public at any given time

3 Occupants at Special Risk

  • Are children employed on the premises ?

  • Are there sleeping occupants ?

  • Are there disabled occupants ?

  • Are there adequate precautions in place for pregnant occupants ?

  • Are there occupants in remote areas ?

  • Are there lone workers ?

4 Previous fire loss experience

  • Is there any previous history of fire loss in the premises ( if yes give details )

5 Other relevant background

  • Are there any residential properties in or attached to the building ?

  • Is there a prohibition notice in force ? ( if yes give details )

  • Is there an alteration notice in force ? ( if yes give details )

  • Is there an enforcement notice in force ? ( if yes give date of when work is to be completed by )

  • Is there any insurance stipulations

  • PART 2 FIRE HAZARDS AND ELIMINATION OR CONTROL

6 Electrical sources of ignition

  • Are reasonable measures taken to prevent fires of electrical origin ?

  • Is the fixed wiring periodically tested and inspected ?

  • Are portable appliances tested/inspected ?

  • Is there suitable policy about the use of personal electrical appliances ?

  • Is there a suitable limitation on the use of trailing leads and adapters ?

  • Is luminous discharge lighting installed ?( if yes does installation meet with currant standards )

  • Is all electrical equipment tested and records on site ?

7 Smoking

  • Are reasonable measures taken to prevent fires as a result of smoking ?

  • Is smoking prohibited in the building ?

  • Is smoking prohibited in appropriate areas ?

  • Are suitable arrangements made for those who wish to smoke ?

  • Is there absence of any evidence of breaches of smoking policy ?

  • Is the appropriate smoking prohibition notice displayed at the buildings entrance ?

8 Arson

  • Does the basic security against arson appear reasonable ?

  • Is there sufficient control of unnecessary fire load in close proximity to the building or available for ignition by outsiders ?

9 Portable heaters and heating installations

  • Is the use of portable heaters avoided as far as reasonably practicable ?

  • If portable heaters are used are the more hazardous types ( radiant bars and LPG ) avoided ?

  • If portable heaters are used are suitable measures taken to minimise the risk of ignition of combustible materials ?

  • Are fixed heater installations subject to regular maintenance ?

10 Cooking Facilities

  • Are reasonable measures taken to prevent cooking fires ?

  • Are filters changed and ductwork cleaned regularly ?

  • Are suitable extinguishers available ?

11 Lightning

  • Does the building have lightning protection system if required ? ( if yes has it been tested and are records kept ?

12 Other significant ignition sources that warrant consideration

  • List other ignition sources

13 Housekeeping

  • Is the standard of housekeeping adequate ?

  • Are combustible materials separate from ignition sources ?

  • Is the unnecessary accumulation of combustibles and waste avoided ?

  • Is there appropriate storage of hazardous materials ?

  • Are combustible materials stored appropriately ?

14 Hazards introduced by contractors and building works

  • Is there sufficient control over works by contractors ( eg. Permits to work and hot works permits ) ?

  • Are there arrangements for the safe storage of gas bottles and other hazardous materials ?

  • Are the safety conditions and instructions communicated to contractors ?

15 Dangerous substances (gas, fuels, flammable liquids, oxidising agents)

  • Are dangerous substances present on the premises ?

  • Has the risk to relevant persons been adequately eliminated or reduced ?

  • PART 3 FIRE PROTECTION MEASURES

16 Means of escape

  • Is the building provided with adequate means of escape in case of fire ?

  • Are there sufficient exits ?

  • Are exits easily and immediately openable where necessary ?

  • Do fire exits open in the direction of travel where necessary ?

  • Have sliding or revolving doors been avoided as fire exits ?

  • Are there adequate means of securing exits ?

  • Are there reasonable distances of travel where there is a single direction of travel ?

  • Are there reasonable distances of travel where there are alternative means of escape ?

  • Are escape routes adequately protected ?

  • Are there suitable fire precautions for all inner rooms ?

  • Are escape routes unobstructed ?

  • Are there suitable means of escape to disabled occupants ?

17 Measures to limit fire spread and development

  • Is there sufficient standard of compartmentation and sub-compartmentation ?

  • Are linings that promote fire spread avoided as far as reasonably practicable ?

  • Are fire doors fitted correctly with a gap not exceeding 4mm

  • Is the door set identified as a fire door?

  • Is the doors hardware fire rated

  • Does the fire door have intumescent strip and or smoke seals correctly fitted

  • Is there any sign of repairs to fire doors?

18 Escape lighting

  • Is there reasonable standard of escape lighting provided ?

  • Is there reasonable standard of escape lighting on any change of level?

19 Fire safety signs and notices

  • Are fire safety signs and notices suitable and sufficient ?

  • Are escape routes clearly signed?

  • Are fire doors clearly signed?

  • Is the fire action notice displayed?

20 Means of giving warning in the event of fire

  • Is a manually operated electrical fire alarm system provided ?

  • Automatic fire detection system provided ?

  • Is there remote transmission of alarm signals ?

21 Manual fire extinguishing appliances

  • Is there suitable and sufficient provision of portable fire extinguishers ?

  • Are extinguishers serviced?

22 Relevant automatic fire extinguishing systems

  • Types of system

  • Comments and observations

23 Facilities, equipment and devices for the protection of fire fighters

  • Types of facilities

  • Comments and observations

  • PART 4 MANAGEMENT OF FIRE SAFETY

24 Procedures and arrangements

  • Person responsible for fire safety

  • Are there competent persons available to assist in implementing fire safety arrangements ?

  • Are appropriate fire procedures in place ? ( including arrangements for calling the fire service )

  • Fire Emergency Plan in place and recorded ?

  • Does the plan take account of other emergency plans applicable in the building ?

  • Is the emergency fire plan readily available for staff to read ?

  • Is the emergency plan available to the enforcing authority ?

  • Are there persons nominated to respond to fire ?

  • Are persons nominated to assist with evacuation ?

  • Is there appropriate liaison with the fire service ?

  • Do routine in-house inspections of fire precautions take place ?

25 Training and drills

  • Are staff given instruction on induction ?

  • Do staff receive periodic refresher training at suitable intervals ?

  • Are staff trained on how to use fire extinguishers?

  • Are fire drills carried out at appropriate intervals ?

26 Testing and maintenance

  • Is the workplace adequately maintained ?

  • Is there weekly testing and periodic servicing of the fire detection and alarm system ?

  • Is there monthly, six monthly, and annual testing of the emergency lighting ?

  • Is there annual maintenance and testing of fire extinguishing equipment ?

  • Is there annual inspection and test of the lightning protection system ?

  • Is there six monthly and annual testing of wet/dry risers ?

  • Is there weekly testing and periodic inspection of sprinkler installations ?

  • Is there routine checks of fire doors and final exit rooms ?

  • Other relevant inspection and test

27 Records

  • Are there records of fire drills ?

  • Are there records of training ?

  • Are there records of fire alarm system ?

  • Are there records of emergency lighting tests ?

  • Are there records of maintenance and testing of other fire protection systems ?

PART 5: SIGNED AND RECEIVED

  • Name and signature of responsible person

  • Assessors name and signature

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