• Building Name and Address:

  • Add media

  • GIA & No. of Floors:

  • Region & Area:

  • Building Use

  • Brief description of building:

  • Occupied by:

  • Reporting Officer:

  • SDM:

  • Date of Visit:

  • Review Date:

Disclaimer and Confidentiality Statement

Disclaimer The assessor believes the information contained within this risk assessment report to be correct at the time of printing. The assessor does not accept responsibility for any consequences arising from the use of the information herein. The report is based on matters which were observed or came to the attention of the assessor during the day of the assessment and should not be relied upon as an exhaustive record of all possible risks or hazards that may exist or potential improvements that can be made.

Confidentiality Statement In order to maintain the integrity and credibility of the risk assessment processes and to protect the parties involved, it is understood that the assessor will not divulge to unauthorised persons any information obtained during this risk assessment unless legally obligated to do so.

Restrictions of Inspection

  • Restrictions of Inspection

Desktop Review

Desktop Review (This is to be undertaken pre-site visit)

  • 0.1 Asbestos Survey: (Yearly)

  • Select date

  • 0.2 Legionella/Water Risk Assessment: In-patient (Two Yearly), Clinics & Health Centres (Three Yearly), Admin (Four Yearly)

  • Select date

  • 0.3 Gas Certificate: (Yearly)

  • Select date

  • 0.4 5 Yearly Electrical Certificate:

  • Select date

  • 0.5 Fire Risk Assessment: (In-patients buildings yearly, clinics two yearly and admin/office buildings three yearly)

  • Select date

  • 0.6 Piped Medical Gas: (Yearly)

  • Select date

  • 0.7 Pressure Vessels: (As per Written Scheme)

  • Select date

  • 0.8 Window Restrictor Survey: (Yearly)

  • Select date

  • 0.9 Lift LOLER Inspection: (6 monthly)

  • Select date

  • 0.10 Generator Full Load Test: (Yearly)

  • Select date

  • 0.11 Lightning Protection

  • Select date

  • 0.12 Hot Surfaces

  • Select date

Security Inspection

General Security - External

  • 1.1 Does the premise have a security alarm?

  • 1.2 Is the boundary fencing in good repair?

  • 1.3 Are garden areas well maintained and not overgrown? (This allows clear visibility)

  • 1.4 Can the roof be easily accessed? (Note, if roof is flat can bins or other structure be used to gain access)

  • 1.5 Are all external areas secure? (Rear parking / waste stores etc)

  • 1.6 Any other pertinent Security Arrangements? (Coded locks, Window Trellis etc)

1. General Security - Reception

  • 1.7 On entering the building, were you challenged or asked who you were?

  • 1.8 Any other accessibility specific issues present?


  • 2.1 Is there CCTV on site?

  • 2.2 Who maintains the CCTV?

  • 2.3 Who is the data controller?

  • 2.4 Is the screen away from public view?

  • 2.5 How many cameras are there on site?

  • 2.6 Do they all work?

  • 2.7 Is the correct signage in place? <br>

  • 2.8 Has an Operational Requirement (OR) and Privacy Impact Analysis (PIA) been undertaken and reviewed?

Building Compliance

3. Asbestos

  • 3.1 Does the building contain asbestos (post 2000), if so, is there an Asbestos Survey/Register on site?

  • 3.2 Is there ACM requiring management in the building?

  • 3.3 Is there a local Asbestos Management Plan?

  • 3.4 Are there any obvious signs of damage to labelled ACM's

  • 3.5 Is there any obvious signs of damage to building fabric i.e. IT drilling through walls?

4. Legionella

  • 4.1 Is there a Water Risk Assessment on site?

  • 4.2 Is there a Water Log Book on site?

  • 4.3 Is the Water Log Book up to date?

  • 4.4 Is there a flushing programme?<br>Note: Infrequently used outlets should be run on at least weekly basis

  • 4.5 Flushing carried out by whom?

  • 4.6 Is there a temperature monitoring programme? <br>Note: Hot 55oc at Outlet and 50oc (min) at return<br>TMVs 41oc Showers/Wash basins and 44-46oc Baths<br>Cold Below 20oc

5. Gas

  • 5.1 Is there evidence that remedial works have been completed?

  • 5.2 Has all gas catering equipment been inspected within the last 12 months?

6. Electrical Safety

  • 6.1 Is there an EICR Report on site?

  • 6.2 Is there evidence that CAT1/CAT2 remedials have been completed?

  • 6.3 Is there a PAT regime in place?

  • 6.4 Is there evidence of sockets being overloaded e.g. Excessive use of extension leads?

  • 6.5 Is NHS PS electrical equipment in good working order? (No damage)

  • 6.6 Is access to live high/low voltage equipment restricted to authorised people only?

  • 6.7 Have all socket covers been removed from the sockets - (CAS alert EFA/2016/002)

  • 6.8 Are 'Fixed Appliances' subject to regular testing?

7. Lifts

  • 7.1 Is there evidence of Lift Servicing (3 monthly)?

  • 7.2 Is there a local breakdown / entrapment procedure?

  • 7.3 Is the emergency call button tested weekly by tenant?

8. Pressure Vessels

  • 8.1 Are there pressure vessels within the building which are landlord responsibility?

  • 8.2 Are examinations being carried out in accordance with the Written Scheme?

  • 8.3 Is there any evidence of maintenance of Pressure Vessels e.g. Valves, steam traps and filters?

9. Medical Gas

  • 9.1 Is there piped medical gas on site?

  • 9.2 Is there a MGPS Operating Procedure on site by the Clinical Provider?

  • 9.3 Has a designated nursing officer been named?

  • 9.4 Is there bottled gas on site?

  • 9.5 Is the bottled gases store as per HTM and HSE Guidance?<br>Signage<br>Keep cylinders chained or clamped to prevent them from falling over<br>Store oxygen cylinders in a well-ventilated area away from combustible materials

10. Generators

  • 10.1 Are generators used at this building?

  • 10.2 Is there evidence of monthly full load testing being completed?

  • 10.3 Is there evidence of maintenance on site?

11. Windows

  • 11.1 Has the building had a window restrictor survey undertaken?

  • 11.2 Has Clinical Provider undertaken a Risk Assessment for falls from windows?

  • 11.3 Are windows and frames in good visual condition?

  • 11.4 Are windows functioning and fully operational?

  • 11.5 Fully open window gap less than 100mm?

  • 11.6 Tamper proof restrictor fixings?

  • 11.7 Fittings could withstand excessive force?

  • 11.8 Additional control measures required (if any):

  • 11.9 Are blinds in a safe condition where children under 42 months are present e.g. No looped cord / chain mechanism? (CAS Alert EFA/2015/001)

12. Automatic Doors

  • 12.1 Has the property got automatic doors?

  • 12.2 Is there evidence of a maintenance regime on site?

13. Fire

  • 13.1 Is there a Fire Risk Assessment on site to confirm provided to tenants?

  • 13.2 Is there evidence that remedial actions stated in the Fire Risk Assessment are in progress or have been completed?

  • 13.3 Is there any evidence of any significant changes since the last Assessment?

  • 13.4 Is the Fire Log Book up to date?

  • Weekly Alarm Test

  • Alarm Service (Annual)<br>This can be complete via 4x quarterly or 2x6 monthly

  • Emergency Lighting Monthly

  • Emergency Lighting 3hr Annual

  • 6 month Fire Door check

  • 13.5 Are fire action notices located at call points? Do they clearly state the location of the Assembly Point?

  • 13.6 Can all fire escapes be used as a means of escape to a safe area? Can all fire exits open easily and without the use of a key?

  • 13.7 Is there a fire zone map located beside the fire panel?

  • 13.8 Is there a fire evacuation plan in place?

  • 13.9 IT Hub Rooms / Comms Rooms - Are gas suppression systems subject to regular maintenance?

  • 13.10 IT Hub Rooms / Comms Rooms - Are UPS systems subject to regular maintenance?

14. Display Energy Certificate

  • 14.1 Is an up to date Display Energy Certificate (DEC) displayed in a prominent location, where applicable? <br>Note: Sites with GIA over 250m2 only

15. Radiators

  • 15.1 Has a hot surfaces assessment been undertaken for communal areas?

  • 15.2 Has Clinical Provider undertaken a Risk Assessment for hot surfaces in their demised areas?

  • 15.3 Are radiators covered?

  • 15.4 Any exposed pipe work covered?

16. Incidents

  • Are staff aware of how and when to report incidents to NHS PS?

17. Chemicals

  • 17.1 Are Hazardous Substances used on site?

  • 17.2 Are they securely stored?

  • 17.3 If our responsibility, are COSHH Risk Assessments available for substances in use? (Our Soft FM Cleaners etc)

18. Housekeeping

  • 18.1 Is the standard of cleaning good?

  • 18.2 Is the building clear of rubbish?

  • 18.3 Are Clinical Waste storage solutions suitable? Any issues reported?

  • 18.4 Are Domestic Waste storage solutions suitable? Any issues reported?

19. Lighting

  • 19.1 Are internal lighting levels adequate? (Offices = 500LUX / Meeting rooms = 300LUX / Car Park 20-50LUX)

  • 19.2 Are internal light fittings operable and routes adequately lit?

  • 19.3 Are external light levels adequate?

  • 19.4 Are external light fittings operable?

20. Environment (Internal)

  • 20.1 Is there adequate space for staff to work safely?

  • 20.2 Is ventilation adequate?

  • 20.3 Are there any slip, trip, fall hazards?

  • 20.4 Are handrails secured e.g stairways, disabled toilets etc?

  • 20.5 Is floor covering in good condition? (Not worn or damaged)

  • 20.6 Any significant deterioration of the building fabric? (IT drilling through walls etc?)

21. Environment (External)

  • 21.1 Are adequate disabled car park spaces available e.g. Minimum 1 bay for every 50 non-disabled bays?

  • 21.2 Is there adequate separation of vehicles and pedestrians?

  • 21.3 Are grit bins provided and procedures in place to ensure used in winter conditions?

  • 21.4 Are there any smoking related issues? E.g. Cigarettes on ground

  • 21.5 Are there any slip, trip or fall hazards?

  • 21.6 Any significant deterioration of the building fabric?

  • 21.7 Are large trees subject to regular inspections and maintenance?

22. Welfare

  • 22.1 Is a staff room provided?

  • 22.2 Are the toilets in good repair?

  • 22.3 Is hot water available?

  • 22.4 Are staff changing rooms available?

  • 22.5 Is drinking water provided?

23. Contractor Management

  • 23.1 Is the Site Log book including risk assessments available?

  • 23.2 Is there evidence to show the log book is being used?

  • 23.3 Have the contractors been inducted to site?

24. First Aid

  • 24.1 Are first aid kits available on site?

  • 24.2 Would an NHS PS staff member have access to a first aider?

  • 23.3 Are first aid notices present and up to date?

25. Signage

  • 25.1 Appropriate signage in place for specific hazards? E.g. Plant rooms, hot water etc?

  • 25.2 Any issues with way-finding signage?

26. Pest Control

  • 26.1 Any obvious Pest issues?

  • 26.2 If yes, are controls in place?

  • 26.3 Are there any situations identified that could cause Pest issues?


27. NHS PS staff base

  • 27.1 Is there a Health and Safety Law Poster on site (new version) where NHS PS staff are based?

  • 27.2 Is there evidence of compliance with the Lone Working Policy (where applicable)?

  • 27.3 Are there sufficient trained First Aiders / appointed persons on site?

  • 27.4 Are there sufficient, well stocked, in date first aided boxes on site?

  • 27.5 Do NHS PS staff know where to access policies?

  • 27.6 Are spill kits available and staff trained to deal with spillages, where applicable?

  • 27.7 Are NHS PS staff aware of the safe handling of sharps and the needle stick injury process?

Additional Issues

28. Any Additional Issues?

  • 28.1

  • 28.2

  • 28.3

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.