PCFRA sec.6

• Property address

• Post code

• Residents initials only

• Conducted on

  Date

• Prepared by

• Location
  Address

Behavioural Consideration

• 6.1 Does the resident smoke cigarettes?

  Yes

  No

• 6.2 Does the resident use cooking equipment i.e. Oven, Microwave or Deep Fat Fryer?

  Yes

  No

• 6.2.a Does the resident leave their cooking unattended?

  Select a) Never b) Occasionally c) Often d) Always

  • a) Never
  • b) Occasionally
  • c) Often
  • d) Always

• 6.3 Does the resident use extension leads, adaptors or electric blankets?

  Yes

  No

• 6.3.a Are these items used safely?

  Yes

  No

• 6.4 Does the resident use portable heaters?

  Yes

  No

• 6.4.a Are these items used safely?

  Yes

  No

• 6.5 Does the resident use candles regularly in their property?

  Yes

  No

• 6.5.a Are these items used safely?

  Yes

  No

• 6.6 Does the resident drink alcohol?

  Yes

  No

• 6.6.a Does alcohol affect the resident's ability to handle smoking materials or cooking?

  Yes

  No

Hoarding

• 6.7.a Does the resident have trouble discarding items that most people would dispose of?

  Yes

  No

• 6.7.b Does the resident buy items or acquire free things they do not need or have space for?

  Yes

  No

• 6.7.c Do the number of possessions in the resident's home make it difficult to use the rooms or surfaces.

  Yes

  No

• 6.7.d Where is the build-up confined to?

  Select a) One room b) More than one room c) Means of escape

  • a) One room
  • b) More than one room
  • c) Means of escape

Comments

• Add any comments and observations