Title Page
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Manager / Proprietor
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Assessment No.
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Health Premises No.
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Date
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Inspection Frequency
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Prepared by
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Premises Address
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INSTRUCTIONS
1. Please answer "Compliant", "Non-Compliant" or "N/A" on the questions below.
2. Add Photos and Notes by clicking on the Paperclip icon
3. To add a Corrective Action click on the Paperclip icon then "Add Action", provide a description, assign to a member, set priority, and due date
4. Complete audit by providing digital signature
5. Share your report by exporting as PDF, Word, Excel or Web Link
Certification and documentation
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Certificate of approval displayed
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Emergency lighting maintenance records
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Evacuation plan
Steps and landing
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Guard rails provided where required
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Hand rails where required
Exit and egress
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Exit doors open in direction of egress
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Exit doors not fitted with barrel bolts
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Exits unobstructed
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Exit signs visible and illuminated
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‘NO ESCAPE’ signs where required
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‘EMERGENCY EXIT’ signs where required
Fans and heaters
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Fixed fans >2.4m above floor level
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Heaters >2.1m above floor
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Heaters >0.6m from combustible ceilings
Sanitary facilities
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Gender signage
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Adequate lighting
Fire prevention and control
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Stage curtains fire retardant
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Fire equipment maintained
Lighting
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Interior lighting adequate
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No bare lamps <2.4m from floor level
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External lighting adequate
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All exits and exit paths lighting adequate
General maintenance
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Materials, fittings, seating, appliances etc are maintained and in a fit sanitary condition
Seating
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Fixed seating secured in groups of 4
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Aisles provided on either side of rows, where seats arranged in rows of 10 to 42
Public buildings used for entertainment
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Compliance with Part 5, Division 2
Completion
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General Comments
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Assessed by: (Officer's Name and Signature)
