Fire Risk Assessment Template Checklist

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Fire Risk Assessment Template

This general assessment template aims to identify and reduce the risk of fire and can be used everywhere. It is divided into three sections: First section covers detailed information about the building and occupants. The second section focuses on identifying hazards and control measures. Lastly, the third section sums up the assessment by generalizing the observation of the two components: 1) Likelihood of fire and 2) Consequences of fire

Information

GENERAL INFORMATION

The Premises

Number of Floors

Brief details about the construction

Use of the premises

The Occupants

Approximate maximum number

Number of Sleeping Occupants

Number of Disabled Occupants

Number of Minor Occupants

Number of Elderly Occupants

Others

Hazard and Risk Identification

HAZARD AND RISK FACTORS

What are the factors present in the inspected area? You may choose multiple items. *You may also add photos, notes, and actions by clicking the paperclip icon.

Smoking
Cooking
Electrical
Portable Heaters
Use of Candles
Deliberate Ignition
Alcohol or Drug Use
Hoarding (Access)
Oxygen
Sensory Impairment
Arson
Housekeeping
Dangerous Substances
Other factors

Select a circumstance observed

Please provide further information here

Select a circumstance observed

Please provide further information here

Including equipment and extensive use of extension leads and adapters and/or electric blankets

Select a circumstance observed

Please provide further information here

Select a circumstance observed

Please provide further information here

Select a circumstance observed

Please provide information here

Select a circumstance observed

Please provide further information here

Select a circumstance observed

Please provide further information here

Select a circumstance observed

Please specify

Use of oxygen combined with high fire risk behavior

Are there other details observed?

Provide further information here

Select a circumstance observed

Please specify further details observed

Detail

Provide information here

Select a circumstance observed

Provide further information here

Select a circumstance observed

Provide further information here

Select a circumstance observed

Please list factors not mentioned above and provide further details to each.

Risk Factor

State them here

Fire Protection Measures

FIRE PROTECTION MEASURES

1. Means of Escape from Fire

It is considered that the premises are provided with reasonable means of escape in case of fire

Has adequate design of escape routes?

Has adequate provision of exits?

Exits easily and immediately openable where necessary?

Fire exits open in direction of escape where necessary?

Avoidance of sliding or revolving doors as fire exits where necessary?

Satisfactory means for securing exits?

Has alternative means of escape?

Escape routes unobstructed?

It is considered that the premises are provided with reasonable arrangements for means of escape for disabled people.

2. Emergency Escape Lighting

Has reasonable standard of emergency escape lighting provided?

Fire Safety Signs and Notices

Has reasonable standard of fire safety signs and notices?

3. Means of Giving Warning in case of Fire

Has reasonable manually operated electrical fire alarm system provided?

Has automatic fire detection provided?

Has remote transmission of alarm signals?

4. Manual Fire Extinguishing Appliances

Has reasonable provision of portable fire extinguishers?

Hose reels provided?

Are all fire extinguishing appliances readily accessible?

5. Procedures and Arrangements

Are procedures in the event of fire appropriate and properly documented?

Are there suitable arrangements for Summoning the fire and rescue service?

Are there suitable arrangements to meet provide relevant information, including that related to hazards to firefighters?

Are there suitable arrangements for ensuring that the premises have been evacuated?

Is there a suitable fire assembly point(s)?

Are there adequate procedures for evacuation of any disabled people who are likely to be to be present?

Persons nominated and trained to use fire extinguishing appliances?

Persons nominated and trained to assist with evacuation, including the evacuation of disabled people?

6. Training and Drills

Are all staff/members given adequate fire safety instruction and training?

7. Testing and Maintenance

Has adequate maintenance of premises?

Has weekly testing and periodic servicing of fire detection and alarm system?

Has monthly and annual testing routines for emergency escape lighting?

Has annual maintenance of fire extinguishing appliances?

Has periodic inspection of external escape staircases and gangways?

Has weekly and monthly testing, six monthly inspections and annual testing of firefighting lifts?

Has weekly testing and periodic inspection of sprinkler installations?

Has routine checks of final exit doors and/or security fastenings?

Has annual inspection and testing of lightning protection system?

8. Records
Appropriate records of:

Fire drills?

Fire training?

Fire alarm tests?

Emergency escape lighting tests?

Maintenance and testing of other fire protection Systems?

Overall Assessment

The following simple fire risk level estimator is based on a commonly used health and safety risk level estimator.

table 1.PNG

DEFINITION OF TERMS (Risk from Fire)

table 2.PNG

Taking into account the fire prevention measures observed at the time of this risk assessment, it is considered that the risk from fire (likelihood of fire) at these premises is:

DEFINITION OF TERMS (Risk Assessment)

TABLE 3.PNG

Taking into account the nature of the premises and the occupants, as well as the fire protection and procedural arrangements observed at the time of this fire risk assessment, it is considered that the consequences for life safety in the event of fire would be:

DEFINITION OF TERMS (Risk Level)

TABLE 4.PNG

Accordingly, it is considered that the risk to life from fire at these premises is:

COMPLETION

Name of Responsible Person and Signature

Assessor's Name and Signature

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.