Title Page

  • Document No.

  • Fire and Smoke Door Inspection

  • Northside Hospital Systems

  • Conducted on

  • Prepared by

  • Location
  • Personnel

1.1

Fire or Smoke Door

  • Fire Door

  • Smoke Door

  • Rating (hr/min):

  • Door Location

  • Door Number

Fire and Smoke Door Inspection

  • 1. Is the door damaged or missing parts?

  • 2. Are the open holes or breaks in the surface of the door or door frame?

  • 3. Does the Door have a glass panel and is it appropriately labeled?

  • 4. Does the door close on it own and latch properly?

  • 5. Is the door hardware damaged?

  • 6. Does the door have any auxiliary items attached to the door or the door frame?

  • 7. Does the door or frame have any field modifications?

  • 8. Does the door coordinator allow the inactive leaf to close before the active leaf?

  • 9. Does the bottom clearance for the door exceed 3/4"?

  • 10. If chains or cables are being used are they overly stretched or show excessive wear?

  • 11. Does the door show signs of dry rot?

  • 12. Does the door and frame have an identifiable fire or Smoke Door label?

  • 13. Has the Fire Door, Smoke Door, or Frame label been painted or visibly obscured?

  • Unit/Floor Manager or Supervisor

  • Life Safety Compliance Inspector

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. Any ratings or scores displayed in our Public Library have not been verified by SafetyCulture for accuracy. Users of our platform may provide a rating or score that is incorrect or misleading. You should independently determine whether the template is suitable for your circumstances. You can use our Public Library to search based on criteria such as industry and subject matter. Search results are based on their relevance to your search and other criteria. We may feature checklists based on subject matters we think may be of interest to our customers.