Information
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Client / Site
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Conducted on
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Prepared by
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Add media
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Add a Summary
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PART 1 GENERAL INFORMATION
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Name of responsible person
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Contact details of responsible person
1 The Building
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Number of floors
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Floor area (m2 per floor)
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Floor area (m2 total)
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Brief details of construction
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Occupancy type
2 The Occupants
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Maximum number of occupants
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Maximum number of occupants
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Maximum number of occupants at any given time
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Maximum number of members of the public at any given time
3 Occupants at Special Risk
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Are children employed on the premises?
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Are there sleeping occupants?
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Are there disabled occupants?
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Are there occupants in remote areas?
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Are there lone workers?
4 Previous fire loss experience
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Is there any previous history of fire loss in the premises (if yes give details)
5 Other relevant background
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Are there any residential properties in or attached to the building?
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Is there a prohibition notice in force ? (if yes give detail)
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Is there an enforcement notice in force ? (if yes give date of when work is to be completed by)
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Is there an alteration notice in force ? (if yes give details)
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PART 2 FIRE HAZARDS AND ELIMINATION OR CONTROL
6 Electrical sources of ignition
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Are reasonable measures taken to prevent fires of electrical origin?
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Is the fixed wiring periodically tested and inspected?
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Are portable appliances tested/inspected?
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Is there suitable policy about the use of personal electrical appliances?
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Is there a suitable limitation on the use of trailing leads and adapters?
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Is luminous discharge lighting installed? (if yes does installation meet with currant standards)
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Is all electrical equipment tested and records on site?
7 Smoking
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Are reasonable measures taken to prevent fires as a result of smoking?
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Is smoking prohibited in the building?
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Is smoking prohibited in appropriate areas?
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Are suitable arrangements made for those who wish to smoke?
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Is there absence of any evidence of breaches of smoking policy?
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Is the appropriate smoking prohibition notice displayed at the buildings entrance?
8 Arson
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Does the basic security against arson appear reasonable?
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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
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Is the use of portable heaters avoided as far as reasonably practicable?
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If portable heaters are used are the more hazardous types ( radiant bars and LPG ) avoided?
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If portable heaters are used are suitable measures taken to minimise the risk of ignition of combustible materials?
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Are fixed heater installations subject to regular maintenance ?
10 Cooking Facilities
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Are reasonable measures taken to prevent cooking fires?
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Are filters changed and ductwork cleaned regularly?
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Are suitable extinguishers available?
11 Lightning
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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
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List other ignition sources
13 Housekeeping
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Is the standard of housekeeping adequate?
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Are combustible materials separate from ignition sources?
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Is the unnecessary accumulation of combustibles and waste avoided?
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Is there appropriate storage of hazardous materials?
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Are combustible materials stored appropriately?
14 Hazards introduced by contractors and building works
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Is there sufficient control over works by contractors (eg. Permits to work and hot works permits?)
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Are there arrangements for the safe storage of gas bottles and other hazardous materials?
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Are the safety conditions and instructions communicated to contractors?
15 Dangerous substances
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Are dangerous substances present on the premises?
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Has the risk to relevant persons been adequately eliminated or reduced?
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PART 3 FIRE PROTECTION MEASURES
16 Means of escape
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Is the building provided with adequate means of escape in case of fire?
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Are there sufficient exits?
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Are exits easily and immediately openable where necessary?
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Do fire exits open in the direction of travel where necessary?
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Have sliding or revolving doors been avoided as fire exits?
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Are there adequate means of securing exits?
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Are there reasonable distances of travel where there is a single direction of travel?
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Are there reasonable distances of travel where there are alternative means of escape?
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Are escape routes adequately protected?
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Are there suitable fire precautions for all inner rooms?
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Are escape routes unobstructed?
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Are there suitable means of escape to disabled occupants?
17 Measures to limit fire spread and development
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Is there sufficient standard of compartmentation and sub-compartmentation?
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Are linings that promote fire spread avoided as far as reasonably practicable?
18 Escape lighting
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Is there reasonable standard of escape lighting provided?
19 Fire safety signs and notices
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Are fire safety signs and notices suitable and sufficient?
20 Means of giving warning in the event of fire
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Is a manually operated electrical fire alarm system provided?
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Automatic fire detection system provided ?
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Is there remote transmission of alarm signals?
21 Manual fire extinguishing appliances
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Is there suitable and sufficient provision of portable fire extinguishers?
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Are hose reels provided?
22 Relevant automatic fire extinguishing systems
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Types of system
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Comments and obsevations
23 Facilities, equipment and devices for the protection of fire fighters
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Types of facilities
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Comments and observations
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PART 4 MANAGEMENT OF FIRE SAFETY
24 Procedures and arrangements
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Person responsible for fire safety
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Are there competent persons available to assist in implementing fire safety arrangements?
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Are appropriate fire procedures in place? (including arrangements for calling the fire service)
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Fire Emergency Plan in place and recorded?
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Does the plan take account of other emergency plans applicable in the building?
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Is the emergency fire plan readily available for staff to read?
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Is the emergency plan available to the enforcing authority?
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Are there persons nominated to respond to fire?
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Are persons nominated to assist with evacuation?
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Is there appropriate liaison with the fire service?
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Do routine in-house inspections of fire precautions take place?
25 Training and drills
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Are staff given instruction on induction?
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Do staff receive periodic refresher training at suitable intervals?
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Are staff with special responsibilities given appropriate training?
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Are fire drills carried out at appropriate intervals?
26 Testing and maintenance
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Is the workplace adequately maintained?
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Is there weekly testing and periodic servicing of the fire detection and alarm system?
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Is there monthly, six monthly, and annual testing of the emergency lighting?
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Is there annual maintenance and testing of fire extinguishing equipment?
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Is there annual inspection and test of the lightning protection system?
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Is there six monthly and annual testing of wet/dry risers?
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Is there weekly testing and periodic inspection of sprinkler installations?
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Is there routine checks of fire doors and final exit rooms?
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Other relevant inspection and test
27 Records
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Are there records of fire drills?
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Are there records of training?
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Are there records of fire alarm system?
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Are there records of emergency lighting tests?
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Are there records of maintenance and testing of other fire protection systems?
PART 5: RISK RATING AND RECOMMENDATIONS
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ITEM 1
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Item
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Probability (likelihood of fire)
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Consequence (impact on life safety)
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Risk rating score
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Recommendations
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Action
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ITEM 2
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Item
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Probability (likelihood of fire)
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Consequence (impact on life safety)
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Risk rating score
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Recommendations
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Action
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ITEM 3
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Item
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Probability (likelihood of fire)
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Consequence (impact on life safety)
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Risk rating score
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Recommendations
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Action
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ITEM 4
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Item
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Probability (likelihood of fire)
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Consequence (impact on life safety)
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Risk rating score
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Recommendations
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Action
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ITEM 5
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Item
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Probability (likelihood of fire)
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Consequence (impact on life safety)
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Risk rating score
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Recommendations
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Action
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ITEM 6
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Item
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Probability (likelihood of fire)
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Consequence (impact on life safety)
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Risk rating score
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Recommendations
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Action
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ITEM 7
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Item
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Probability (likelihood of fire)
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Consequence (impact on life safety)
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Risk rating score
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Recommendations
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Action
PART 6: SIGNED AND RECEIVED
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Name and signature of responsible person
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Assessors name and signature