Fire Warden Monthly Checksheet

• Conducted on

  Date

• Audit Title

• Prepared by

• Location
  Address

Fire Extinguishers

• Are extinguishers in labelled locations?

  Yes

  No

  N/A

• Are extinguisher pins in place and seals unbroken (for 2016/17 the extinguisher pins are green)?

  Yes

  No

  N/A

• Are extinguishers easily accessible and unobstructed?

  Yes

  No

  N/A

• If a gauge is fitted, is the needle in the green zone?

  Yes

  No

  N/A

Fire Escape Routes

• Are emergency exit routes clearly signposted?

  Yes

  No

  N/A

• Are escape routes clear and free of obstruction?

  Yes

  No

  N/A

• Do fire doors self close effectively into the door frame?

  Yes

  No

  N/A

• Are fire doors kept closed (not held/wedged open)?

  Yes

  No

  N/A

Fire Safety Notices and Signs

• Are all fire safety notices and signs clearly visible and not defaced?

  Yes

  No

  N/A

• Are fire action notices in place and do they indicate the location of the Fire Assembly Point?

  Yes

  No

  N/A

• Is the sign at the Fire Assembly Point in place, clearly visible and undamaged?

  Yes

  No

  N/A

Fire Exits

• Are final exits from buildings clear of instructions, both inside and outside the building?

  Yes

  No

  N/A

• Can emergency exits be opened without the use of a key?

  Yes

  No

  N/A

• Is the Fire Assembly Point clearly identifiable and it is in a clear safe away from traffic?

  Yes

  No

  N/A

Electrical Equipment

• Are all electric cables tidy and free from trip hazards?

  Yes

  No

  N/A

• Are all extension cables fully extended (uncoiled) and routed safely?

  Yes

  No

  N/A

• Is there evidence of temporary repair of or damage to electrical equipment?

  Yes

  No

  N/A

Heating Equipment

• Are heaters, flues, vents and hot pipes clear of furniture, clothing, paper or other combustible materials?

  Yes

  No

  N/A

General Housekeeping

• Are all work areas tidy?

  Yes

  No

  N/A

• Is the smoking policy seen to be working?

  Yes

  No

  N/A

• Are packing and stationery materials securely contained and stored?

  Yes

  No

  N/A

• Are flammable materials stored in a secure location?

  Yes

  No

  N/A

• Is combustible waste safely stored away from heat sources and disposed of regularly?

  Yes

  No

  N/A

• Have all issues been addressed since the last check sheet was completed? if not, please explain which are outstanding.

  Yes

  No

  N/A

• Select date

  Date

• Add signature

  Sign

• Fire wardens and ASMs should keep a copy of this form for their records. The Fire Warden should forward the completed form, signed and dated to the appropriate Area Safety Manager. The ASM should forward the completed copy to the SHE Office and action remedial measures where necessary.