Name of the responsible person
Contact details of responsible person
Floor area: (m2 per floor)
Floor area: (m2 total)
Brief details of construction:
Primary use of the building
Maximum number of occupants at any given time:
Maximum number of members of the public at one time:
Are children employed at the premises?
Are there sleeping occupants?
Are there disabled occupants?
Are there occupants in remote areas?
Are there lone workers?
Is there any previous history of fire loss in the premises (if yes give details)
Are there any residential properties in or attached to the building
Is there a prohibition notice in force? (if yes give date of issue)
Is there an alteration notice in force? (if yes give date of issue)
Is there an enforcement notice in force? (if yes give date of issue and date of when work is to be completed by)
Are reasonable measures taken to prevent fires of electrical origin?
Is the fixed wiring installation periodically tested and inspected?
Are portable appliances tested/inspected?
Is there a suitable policy about the use of personal electrical appliances?
Is there a suitable limitation on the use of trailing leads and adapters?
Is Luminous Discharge Lighting installed? (if yes does the installation meet with current standards)
Is smoking prohibited in the building?
Is the appropriate smoking prohibition notice displayed at the building's entrance?
Is smoking prohibited in appropriate areas?
Are reasonable measures taken to prevent fires as a result of smoking?
Are there suitable arrangements made for those who wish to smoke?
Is there any evidence of breaches of smoking policy?
Does the basic security against arson appear reasonable?
Is there sufficient control of unnecessary fire load in close proximity to the building or available for ignition by outsiders?
Is the use of portable heaters avoided as far as reasonably practicable?
If portable heaters are used, are the more hazardous types (radiant bars and LPG) avoided?
If portable heaters are used are suitable measures taken to minimise the risk of ignition of combustible materials?
Are fixed heating installations subject to regular maintenance?
Are reasonable measures taken to prevent cooking fires?
Are filters changed and ductwork cleaned regularly?
Are suitable extinguishers available?
Does the building have an emergency lightning system? (if yes has it been tested and are records of testing kept)
List other ignition sources:
Is the standard of housekeeping adequate?
Are combustible materials separated from ignition sources?
Is the unnecessary accumulation of combustibles and waste avoided?
Is there appropriate storage of hazardous materials?
Are combustible materials stored appropriately?
Is there sufficient control over works by contractors (e.g. Permits to work & hot works permits)?
Are there arrangements for the safe storage of gas bottles and others hazardous materials
Are fire safety conditions and instructions communicated to contractors?
Are dangerous substances present on the premises?
Has the risk to relevant persons been adequately eliminated or reduced?
If yes list evidence
Is the building provided with adequate means of escape in case of fire?
Are there sufficient exits?
Are exits easily and immediately openable where necessary?
Do fire exits open in the direction of travel where necessary?
Have sliding or revolving doors been avoided as fire exits?
Are there adequate means of securing exits?
Are there reasonable distances of travel where there is a single direction of travel?
Are there reasonable distances of travel where there are alternative means of escape?
Are escape routes adequately protected?
Are there suitable fire precautions for all inner rooms?
If yes to the above provide details
Are escape routes unobstructed?
Are there suitable means of escape for disabled occupants?
Is there a sufficient standard of compartmentation and sub-compartmentation?
Are linings that promote fire spread avoided as far as reasonably practicable?
Is there a reasonable standard of escape lighting provided?
Are fire safety signs and notices suitable and sufficient?
Is a manually operated electrical fire alarm system provided?
Is automatic fire detection provided?
Is there remote transmission of alarm signals?
Is there suitable and sufficient provision of portable fire extinguishers?
Are hose reels provided?
Type of system:
Comments and observations:
Types of facilities:
Comments and observations:
Person responsible for fire safety:
Are there competent persons available to assist in implementing fire safety arrangements?
Are appropriate fire procedures in place? (including arrangements for calling the fire service)
Fire Emergency Plan in place and details recorded?
Does the plan take account of other Fire Emergency Plans applicable in the building?
Is the Fire Emergency Plan readily available for staff to read?
Is the Fire Emergency Plan available to the enforcing authority?
Are there persons nominated to respond to fire?
Are persons nominated to assist with evacuation?
Is there appropriate liaison with the fire service?
Do routine in-house inspections of fire precautions take place?
Are staff given instruction on induction?
Do staff receive periodic refresher training at suitable intervals?
Are staff with special responsibilities given appropriate training?
Are fire drills carried out at appropriate intervals?
Is the workplace adequately maintained?
Is there weekly testing and periodic servicing of the fire detection and alarm system?
Is there monthly, six-monthly and annual testing of the emergency lighting?
Is there annual maintenance and testing of fire extinguishing equipment?
Is there annual inspection and test of the lightning protection system?
Is there routine checks of fire doors and final exit doors?
Other relevant inspection and test
Are there records of fire drills?
Are there records of fire training?
Are there records of fire alarm tests?
Are there records of emergency lighting tests?
Are there records of maintenance and testing of other fire protection systems?
Issue to be addressed
Probability (likelihood of fire)
Consequence (impact on life safety)
Person responsible for action