PEEP Assessment

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

Resident Details

• Name of person being assessed

• Address

• Name of person conducting assessment

• Date

• Date of review

PEEP Assessment

• Can you hear the audible fire alarm when it sounds without hearing aids?

  Yes

  No

  N/A

• Add comments

• Do you have a visual impairment which would hinder your escape?<br><br>

  No

  Yes

• Add comments

• Are you able to reach a safe refuge area using stairs if required?

  Yes

  No

  N/A

• Could you find your way to the exit if the normal route was blocked?

  Yes

  No

  N/A

• Add comments

  Yes

  No

  N/A

Further Action

• Enter details on the PEEP and secure in the Secure Information Box

  Completed

  Not Completed

Complete audit

• Has the information been transferred to the PEEP register

  Yes

  No

  N/A

• Signature

  Sign