Title Page

  • Conducted on

  • Prepared by

  • Location


  • A1- Escapes Open Freely

  • A2 -Escapes are free from obstruction

  • A3- Fire signs are in place and lit fire exit signs are working

  • A4- All fire alarm call points have break glass intact

  • A5- All fire assembly points are identified

  • A6- Smoking restricted to smoking areas

  • A7- Fire blankets situated in kitchens

  • A8- All Staff to have recorded annual fire training


  • B1- There are no trailing leads causing hazards

  • B2- There are no wires exposed at the back of plugs and or sockets

  • B3- There is no electrical equipment adjacent to water supply

  • B4-All new electrical equipment to be checked by Estate before use

  • B5- All Electrical equipment to be checked annually


  • C1- All hazardous substances are stored safely and locked out was of access by residents

  • C2- Clinical waste is stored securely

  • C3- Drugs are secure and the cabinet locks properly

  • C4- Equipment such as hoist, trolley wheelchairs is stored safely and does not pose a hazard

  • C5- Clinical equipment is stored securely at all times

  • C6- Drugs and other clinical products and packages are within their use by date

  • C7- Is the first aid box in its proper location

  • C8-Is there any high level storage which creates a risk of items falling or of injury in handling the items when storing or retrieving

  • C9- Are all gas cylinders properly secured, readily available and checked or % content

  • C10- All areas have up-to-date COSHH data


  • D1- Fridge records a temperature below -5 degrees

  • D2- All food preparation surface areas are clean and free from dust, grease, and debris

  • D3-Ovens etc. are kept clean and do not have accumulated dirt

  • D4-Fridge stock are all within use by date with the oldest stored at the front (i.e. there is stock rotation)

  • D5-Dry and other goods are all within the use by dates

  • D6- There is evidence that food serving temperature has been checked at least weekly

  • D7-Safety Area


  • E1- Evidence that checks of kitchen, bath, and shower water temperatures have been undertaken at the frequency required in this location

  • E2- Are all the taps in good order, are there drips or leaks, is the hot/cold indicator present on all taps

  • E3-Are showers not in regular use run by staff for 5 minutes every day


  • F1-Is the home and the area around it free from rubbish, accumulated debris

  • F2- Is the home generally clean and hygienic especially toilet and washroom areas

  • F3- All windows in a safe condition and do window restraints work

  • F4- Are all the lights in working order and gives adequate light for the tasks undertaken

  • F5-Are staff using personal protective equipment as issued and advised to them

  • F6-Are all the flooring in adequate condition not to create risk of tripping or slipping

  • F7-Do all the doors close properly and do the locks on them operate as required

  • F8- Are all door entry systems in working order

  • F9-Is there any flaking paint that could create a hazard

  • F10-Are there any areas of the home particularly where anything has been changed which presents hanging risks or other hazards

  • F11- All corridors are free from storage and furniture

  • F12-Is there sufficient control of fresh air

  • F13- Roof

G. Garden Area

  • G1- Car Park

  • G2- Surrounding walk ways etc

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.