Information

  • Client / Site

  • Add media

  • Conducted on

  • Prepared by

  • PART 1 GENRAL INFORMATION

  • Name of responsible person

  • Contact details of responsible person

1 The Building

  • Number of floors

  • Floor area (m2 per floor)

  • Floor area (m2 total)

  • Brief details of construction

  • Occupancy type

2 The Occupants

  • Maximum number of occupants

  • Maximum number of occupants

  • Maximum number of occupants at any given time

  • 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 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 detail)

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

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

  • 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

  • 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?

18 Escape lighting

  • Is there reasonable standard of escape lighting provided?

19 Fire safety signs and notices

  • Are fire safety signs and notices suitable and sufficient?

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 hose reels provided?

22 Relevant automatic fire extinguishing systems

  • Types of system

  • Comments and obsevations

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 with special responsibilities given appropriate training?

  • 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: RISK RATING AND RECOMMENDATIONS

  • ITEM 1

  • Item

  • Probability (likelihood of fire)

  • Consequence (impact on life safety)

  • Risk rating score

  • Recommendations

  • Action

  • ITEM 2

  • Item

  • Probability (likelihood of fire)

  • Consequence (impact on life safety)

  • Risk rating score

  • Recommendations

  • Action

  • ITEM 3

  • Item

  • Probability (likelihood of fire)

  • Consequence (impact on life safety)

  • Risk rating score

  • Recommendations

  • Action

  • ITEM 4

  • Item

  • Probability (likelihood of fire)

  • Consequence (impact on life safety)

  • Risk rating score

  • Recommendations

  • Action

  • ITEM 5

  • Item

  • Probability (likelihood of fire)

  • Consequence (impact on life safety)

  • Risk rating score

  • Recommendations

  • Action

  • ITEM 6

  • Item

  • Probability (likelihood of fire)

  • Consequence (impact on life safety)

  • Risk rating score

  • Recommendations

  • Action

  • ITEM 7

  • Item

  • Probability (likelihood of fire)

  • Consequence (impact on life safety)

  • Risk rating score

  • Recommendations

  • Action

PART 6: SIGNED AND RECEIVED

  • Name and signature of responsible person

  • Assessors name and signature

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