Health Safety and Welfare Report

• Client

• Location
  Address

• Prepared by

• Conducted on

  Date

• Date of inspection:

  Date

• Persons Met:

• Inspection by:

• Executive Summary

Overall Rating

Management

• Safety Handbook: Is it in place, are recognition forms signed and held on file?

  Yes

  No

  N/A

• Communication - Is it Adequate?

  Yes

  No

  N/A

• Consultation - Is it adequate?

  Yes

  No

  N/A

• Have general risk assessments been recorded?

  Yes

  No

  N/A

• Have DSE Assessments been completed?

  Yes

  No

  N/A

Fire Safety

• Has a Fire risk assessment been completed?

  Yes

  No

  N/A

• Are fire exits accessible and free from obstructions?

  Yes

  No

  N/A

• Do fire exits open easily without use of key?

  Yes

  No

  N/A

• Are fire escape routes all free from obstructions?

  Yes

  No

  N/A

• Means of raising alarm:

  Yes

  No

  N/A

• Smoke detectors-are they in place?

  Yes

  No

  N/A

• Emergency lights- are they in place?

  Yes

  No

  N/A

• Emergency Lights - are the regularly checked /inspected and in good working order?

  Yes

  No

  N/A

• Smoke Detectors are the regularly checked /inspected and in good working order?

  Yes

  No

  N/A

• Fire extinguishers : - Are suitable fire extinguishers provided?

  Yes

  No

  N/A

• Are there any in the correct locations?

  Yes

  No

  N/A

• When were fire extinguishers last tested?

  Date

• Are they wall mounted?

  Yes

  No

  N/A

• Fire Action notices: - Are they displayed in the required locations?

  Yes

  No

  N/A

• Fire Signage: - Does it comply?

  Yes

  No

  N/A

• Date of last fire drill:

  Date

• Signing in/out arrangements for visitors: - Are they suitable?

  Yes

  No

  N/A

• Is the Fire Log Book maintained?

  Yes

  No

  N/A

• Are there any fire hazards?

  Yes

  No

  N/A

Welfare Arrangements

• No. of first aid boxes:

• No. of First Aiders/Appointed Persons:

• First aid notice:

  Yes

  No

  N/A

• Are there sufficient toilets, are they working, clean & tidy?

  Yes

  No

  N/A

• Are soap and hand drying facilities available?

  Yes

  No

  N/A

• Is hot and cold water available?

  Yes

  No

  N/A

• Is drinking water available?

  Yes

  No

  N/A

• Means of making a hot drink?:

  Yes

  No

  N/A

• Means of heating food?:

  Yes

  No

  N/A

• Temperature: Is it reasonable?

  Yes

  No

  N/A

• Ventilation: Is it adequate?

  Yes

  No

  N/A

• Lighting: Is it suitable & sufficient?

  Yes

  No

  N/A

• Yes

  No

  N/A

Hazards

• Floors: Are they sound/level and in good condition?

  Yes

  No

  N/A

• Areas free from tripping and/ or slipping hazards?

  Yes

  No

  N/A

• Is there sufficient storage?

  Yes

  No

  N/A

• Stairs: - are all controls in place?

• Lift : - are all controls in place?

  Yes

  No

  N/A

• Asbestos: - are all controls in place?

  Yes

  No

  N/A

• Manual handling: - are all controls in place?

• Hazardous substances- are all controls in place?

  Yes

  No

  N/A

• Portable appliances testing - When completed?

  Date

• Fixed electrical installation tested in last 5 years?

  Date

• Gas boiler serviced in last 12 months?

  Date

• What security is in place? - Is it adeqaute

  Yes

  No

  N/A

• Housekeeping - Is it effective?

  Yes

  No

  N/A

• Are Legionella Controls Managed Correctly?

  Yes

  No

  N/A