LM Planned General Inspection (Station) V.2014-02

Information

Document No.
Audit Title
Client / Site
Conducted on
Prepared by
Location
Personnel

1 External Areas

1.1 Is the condition of platform surfaces good?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.2 Are white/yellow lines in good condition?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.3 Are any holes, bumps, cracks or obstructions properly marked/guarded?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.4 Is station lighting adequate and working correctly?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.5 Are the following in good condition footbridge/subway/access/ramps/steps and handrails?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.6 Are the following in good condition stairs/escalators/handrails - hazard marked & steps even?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.7 Is the condition of fencing/walls/gates good?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.8 Condition of barrow foot crossing and signs?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.9 Condition of waiting shelters?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.10 Is platform equipment properly secured?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.11 Are contractor's materials/equipment properly secured?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.12 Is the condition of car park surface condition/white lining good?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.13 Public address/Customer information system, does it work, is it clear?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.14 Are waste container(s) covered and secured?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.15 Are 'no trespass signs' at platform ends?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.16 Are the CCTV cameras free from obstruction and no signs of damage?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.17 Are CCTV signs displayed and fit for purpose?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.18 Are CCTV tapes/CD’s being used and stored in line with the company procedure?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.19 Is asbestos signage correctly positioned?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.20 Is every platform traffic route free from obstructions, articles or substances which may cause a person to slip, trip or fall?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.21 Have the platforms an effective means of drainage where necessary?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.22 Where there are fixed ladders fitted to any building structure within the station boundaries are these ladders fitted with safety hoops and do they have means of restricting access by unauthorised users?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.23 Are all external doors and gates suitably constructed and free from damage?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.24 Are contractors working to agreed method statements?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.25 Are all areas designated as ‘building sites’ fenced off and suitably signed?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.26 Is station signage free from obstruction, in good order and visible?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.27 Are all drains free from litter, leaves and any other build up?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
1.28 Are storage lockers (salt bins etc) sealed and locked when not in use?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

2 Internal Areas

2.1 Are staff areas clean and uncluttered?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.2 Is heating and lighting adequate/working?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.3 Are electrical fittings safe with no broken sockets, in date and P.A.T tested etc?.
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.4 Are gas & electrical equipment safety checks in date?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.5 Are walking routes and passenger areas well defined, clear of obstruction and in good condition?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.6 Is There A Thermometer Available?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.7 Are all security locks/doors in good working order?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.8 Workstations - Is the Seating and space adequate?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.9 Is all furniture supplied fit for purpose and correct?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.10 Is a system in place to ensure regular cleaning of the workplace?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.11 Has asbestos been identified correctly (if applicable)
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.12 Is a system in place to ensure regular cleaning of the workplace?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.13 Are the surfaces of the floors, walls and ceilings inside buildings clean?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.14 Are the kitchen, rest rooms and toilets cleaned daily?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.15 Have waste materials been allowed to accumulate? If so, this requires removal
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.16 Is a copy of the LONDON MIDLAND safety policy statement displayed and visible to all staff?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.17 Is a copy of the liability insurance certificate displayed and visible to all staff?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.18 Is there a safety notice board available to all staff at the workplace?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.19 Are the contents of the safety notice board relevant, containing only safety related information included the LONDON MIDLAND safety policy (General Arrangements)?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
2.20 Is a copy of the LONDON MIDLAND environmental policy statement displayed and visible to all staff?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

3 Fire

3.1 Means of Escape

3.1.1 Are fire exit routes clear and free from obstruction?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.1.2 Are fire exit doors correctly signed and easily opened?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.1.3 Is all fire signage clear and free from obstructions?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.1.4 Are all door fastenings easily opened with out a key?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.1.5 Are the seals within the fire doors and fire check doors frames undamaged?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.1.6 Are Fire door closers fitted within the premises and are they in good working order
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

3.2 Fire Alarm Indicator Panel

3.2.1 Is the fire alarm panel electrical supply healthy?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.2.2 Are there any fault lights showing on the fire alarm panel?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.2.3 Are spare fire alarm panel keys available?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.2.4 Does the fire alarm panel indicate normal working?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.2.5 Is there evidence of the system being tested, maintained and serviced within the last 12 months?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

3.3 Break Glass Call Points

3.3.1 Are all Break Glass call points in satisfactory condition?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.3.2 Are there spare break glass covers readily available?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.3.3 Are there test keys available?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.3.4 Are all break glass call points numbered?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.3.5 Is there evidence that break glass call points are tested every week?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.3.6 Where fitted are all automatic detectors visibly satisfactory?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.3.7 Are automatic detectors tested on a regular basis?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.3.8 Is there evidence to demonstrate that fire alarms, break glass call points and automatic detectors are tested and recorded?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.3.9 Are all sound/visual Indicators clear from obstruction and in satisfactory order?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

3.4 Fire Fighting Equipment

3.4.1 Are all fire extinguishers properly located?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.4.2 Are all fire extinguishers easily accessible?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.4.3 Are safety pins and pull tight seals fitted to all fire extinguishers?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.4.4 Are fire extinguishers charged?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.4.5 Have all fire extinguishers been inspected within the last 12 months?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.4.6 Are records of such inspections retained within the fire log book?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.4.7 Is the inspection label fitted to the fire extinguisher marked with the inspection date?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.4.8 Are fire blankets in satisfactory order and within test date?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.4.9 Are fire blankets located within the range of the potential fire risk?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.4.10 Are fire reels in satisfactory order and within test date?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.4.11 Where appropriate and fitted are fire hydrants easily accessible and free from obstructions and signed?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.4.12 Have all fire hydrants been inspected and tested within the last quarter?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.4.13 Are records of inspection, servicing and maintenance contained within the fire log book up to date and current?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

3.5 Fire Procedures

3.5.1 Are fire action notices in good order?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.5.2 Has the annual fire briefing being undertaken within the last 12 months?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.5.3 Has the location undertaken a fire evacuation drill within the last 12 months?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.5.4 Is the fire log book maintained and up to date?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.5.5 Has a Fire Precautions Manager’s inspection been carried within the last 12 months?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.5.6 Has a fire risk assessment been carried out/reviewed within the last 12 months?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

3.6 Housekeeping

3.6.1 Are waste bins provided adequate and sufficient for the type of location?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.6.2 Is the frequency of waste removal by the waste contractor satisfactory?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.6.3 Do all furniture and fixtures allow free and easy access and egress?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.6.4 Are work areas and storage areas tidy?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.6.5 Is storage area/space adequate, tidy with no build up of necessary materials and equipment?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.6.6 Are no smoking areas indicated and maintained as such?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.6.7 Are heating, cooking and lighting appliances maintained in good order?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.6.8 Are all fridges clean?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.6.9 Are all areas for preparing, cooking and eating of food clean?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

3.7 Electrical

3.7.1 Do all electrical instillations and appliance appear to be in good order?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.7.2 Is PAT testing up to date?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.7.3 Is regular inspection, maintenance and testing of electrical equipment carried out by a competent person?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.7.4 Are staff aware of the location of the main switchers?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

3.8 Escape and Emergency Lighting

3.8.1 Is the emergency lighting self contained units?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.8.2 Is there a routine testing regime in place?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.8.3 Are there records of the annual emergency lighting inspection contained within the fire log book?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

3.9 Gas

3.9.1 Does the mains intake (meter cupboard) appear to be in good order, unobstructed and free from combustible materials?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.9.2 Is all visible gas pipe work in good order and labelled appropriately?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.9.3 Are the control valves easily identifiable and labelled?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
3.9.4 Are staff aware of how to isolate the gas mains if necessary?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

4 COSHH Checks

4.1 Are up to date COSHH Assessments/Data Sheets available?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
4.2 Are only those substances authorised present at the location?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
4.2.1 Are flammable liquids stored in accordance with an associated COSHH assessment and in secure flammable lockers?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
4.3 Are control specified measures being observed?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
4.4 Are supplies of paint and chemicals stored and receptacles properly labelled in accordance with instructions?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
4.5 Are storage areas maintained in a tidy condition?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
4.6 Are instructions on hand to explain how to deal with bio hazardous waste?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
4.7 Is the bio hazard bin or sharps available? what is its condition, (empty/full/damaged)
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
4.8 Can staff demonstrate a safe system of work for handling sharps?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

5 Personal Protective Equipment

5.1 Is personal protective equipment available where necessary, including, Gloves, goggles, overalls, head protection, HV vests, spit kits, bio hazard kits or other (please specify)?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
5.2 Where required, are staff wearing the appropriate P.P.E.?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
5.3 Is P.P.E. in efficient working order and in good repair?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
5.4 Are staff able to obtain spare/new PPE as required?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

6 Retail

6.1 Are staff trained for the type of work carried out?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
6.2 Are cash regulations available/adhered to? (booking office only)
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
6.3 Do staff know where there is a copy of the cash regulations?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

7 First Aid/Accidents

7.1 Do first aid boxes have a list of contents and contents used book?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
7.2 Have the contents been checked?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
7.3 Is the accident book available?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
7.4 Indicate when last checked and initialled.
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
7.5 Is first-aid equipment positioned where it is easily accessible at all times?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
7.6 Are the contents of the first aid box appropriate for the hazards encountered at the particular workplace?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

8 Equipment

8.1 Is an up to date plant and machinery inventory available?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
8.2 Are equipment/chemicals available for snow/ice clearing?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
8.3 Is there a microwave test certificate available and in date?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
8.4 Is a hand lamp available?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
8.5 Are records kept of powered plant in use and do they have current certificates including lifts and escalators (statutory insp books)?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
8.6 Do staff or contractors operating powered plant hold in date certificates of proficiency?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
8.7 Are staff operating manually operated equipment authorised?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
8.8 Are ladders in use marked with date of examination?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
8.9 Have out-of-date/damaged ladders been taken out of use?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
8.10 Are contractors observed working safely?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
8.11 Are portable ramps maintained and in good condition?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
8.12 When not being used, has the machinery been left in a state where it does not present a hazard?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

9 Environmental

9.1 Is waste being segregated at this location in line with company standards?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
9.2 Are all lights/electrical equipment that are not in use, switched off?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
9.3 Is track clear of oil and toilet waste?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
9.4 Is the leased area free from Japanese knotweed growth?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

10 Security

10.1 Are panic /burglar alarms tested on a periodic basis and records maintained?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
10.2 Are all waste bins/salt bins sealed and secure when not in use?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
10.3 Are all non public access areas secure from unauthorised access?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
10.4 Are security checks being carried out and records maintained?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
10.5 Where security locks/padlocks are used are they in good working order and being used correctly?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
10.6 Are security announcements being made as required?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
10.7 Are staff aware of the bomb/security procedures?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
10.8 Do staff requiring ID cards have them with them and are they in date
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

11 Asbestos Managemnt

11.1 Staff aware of asbestos location & instructions?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
11.2 Is there an asbestos register on site?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
11.3 Are asbestos containg materials labbled as per the asbestos register on site?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
11.4 Is asbestos monitored?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

12 Visitors and Contractors

12.1 Have all visitors/contrcators to site signed in?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
12.2 Have all vistors/contrcators to site recived a local site induction?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
12.3 Have records been reatined of visitor/contractors induction?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
12.4 Are only authorised contractors on site?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
12.5 Have any inspections of contractors been carried out?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

13 Location Specific Checks

13.1 Are evacuation boxes sealed and in order?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
13.2 Is the wheelchair in good order?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
13.3 Are all Radios in order?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
13.4 Are Emergency Dressing Packs in order?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
13.5 Are 'Gun Shot Wound' packs and Oxygen in order?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed
13.6 Are Defibrillator Machines in Order?
Risk Rating
- High
- Medium
- Low
What IMMEDIATE action (or action on previous inspections) has been taken to reduce risk?
Date action taken
What LONG TERM action is required?
Fault Reference Number
Date Reported
Target Date for completion of Long Term Action
Date Long Term Action Closed

LM Planned General Inspection (Station) V.2014-02

Go digital today!

Convert your paper checklists into digital forms

1 External Areas

2 Internal Areas

3 Fire

3.1 Means of Escape

3.2 Fire Alarm Indicator Panel

3.3 Break Glass Call Points

3.4 Fire Fighting Equipment

3.5 Fire Procedures

3.6 Housekeeping

3.7 Electrical

3.8 Escape and Emergency Lighting

3.9 Gas

4 COSHH Checks

5 Personal Protective Equipment

6 Retail

7 First Aid/Accidents

8 Equipment

9 Environmental

10 Security

11 Asbestos Managemnt

12 Visitors and Contractors

13 Location Specific Checks

Related checklists

LM Planned General Inspection (Station) V.2014-02

Free LM Planned General Inspection (Station) V.2014-02 Checklist

Go digital today!

Convert your paper checklists into digital forms

1 External Areas

2 Internal Areas

3 Fire

3.1 Means of Escape

3.2 Fire Alarm Indicator Panel

3.3 Break Glass Call Points

3.4 Fire Fighting Equipment

3.5 Fire Procedures

3.6 Housekeeping

3.7 Electrical

3.8 Escape and Emergency Lighting

3.9 Gas

4 COSHH Checks

5 Personal Protective Equipment

6 Retail

7 First Aid/Accidents

8 Equipment

9 Environmental

10 Security

11 Asbestos Managemnt

12 Visitors and Contractors

13 Location Specific Checks

Related checklists