Regulatory Reform (Fire Safety) Order 2005,

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Part 1: GENERAL INFORMATION

The responsible person for fire safety

• Name of the responsible person

• Contact details of responsible person

1 The Building

• Number of Floors

  Select 1 2 3 4 5 6 7 8 9 10

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10

• Floor area: (m2 per floor)

• Floor area: (m2 total)

• Brief details of construction:

• Occupancy type:

2 The occupants

• Maximum number of occupants:

• Maximum number of occupants at any given time:

• Maximum number of members of the public at one time:

3 Occupants at special risk

• Children employed at the premises?

  Yes

  No

• Employee's sleeping at the premises overnight?

  Yes

  No

• Are disabled occupants catered for?

  Yes

  No

  N/A

• Are there occupants in remote areas?

  Yes

  No

• Are there lone workers?

  Yes

  No

4 Previous Fire loss experience

• Is there any previous history of fire loss in the premises (if yes give details)

  Yes

  No

5 Other relevant background

• Are there any residential properties in or attached to the building

  Yes

  No

• Is there a prohibition notice in force? (if yes give date of issue)

  Yes

  No

• Is there an alteration notice in force? (if yes give date of issue)

  Yes

  No

• Is there an enforcement notice in force? (if yes give date of issue and date of when work is to be completed by)

  Yes

  No

Part 2: FIRE HAZARDS AND ELIMINATION OR CONTROL

6 Electrical sources of ignition

• Are reasonable measures taken to prevent fires of electrical origin?

  Yes

  No

  N/A

• Is the fixed wiring installation periodically tested and inspected?

  Yes

  No

  N/A

• Are portable appliances tested/inspected?

  Yes

  No

  N/A

• Is there a suitable policy about the use of personal electrical appliances?

  Yes

  No

  N/A

• Is there a suitable limitation on the use of trailing leads and adapters?

  Yes

  No

  N/A

• Is Luminous Discharge Lighting installed? (if yes does the installation meet with current standards)

  Yes

  No

  N/A

• Is all electrical equipment tested and records on site

  Yes

  No

  N/A

7 Smoking

• Are reasonable measures taken to prevent fires as a result of smoking?

  Yes

  No

  N/A

• Is smoking prohibited in the building?

  Yes

  No

  N/A

• Is smoking prohibited in appropriate areas?

  Yes

  No

  N/A

• Are there suitable arrangements made for those who wish to smoke?

  Yes

  No

  N/A

• Is there absence of any evidence of breaches of smoking policy?

  Yes

  No

• Is the appropriate smoking prohibition notice displayed at the building's entrance?

  Yes

  No

  N/A

8 Arson

• Does the basic security against arson appear reasonable?

  Yes

  No

  N/A

• Is there sufficient control of unnecessary fire load in close proximity to the building or available for ignition by outsiders?

  Yes

  No

  N/A

9 Portable heaters and heating installation

• Is the use of portable heaters avoided as far as reasonably practicable?

  Yes

  No

  N/A

• If portable heaters are used, are the more hazardous types (radiant bars and LPG) avoided?

  Yes

  No

  N/A

• If portable heaters are used are suitable measures taken to minimise the risk of ignition of combustible materials?

  Yes

  No

  N/A

• Are fixed heating installations subject to regular maintenance?

  Yes

  No

  N/A

10 Cooking facilities

• Are reasonable measures taken to prevent cooking fires?

  Yes

  No

  N/A

• Are filters changed and ductwork cleaned regularly?

  Yes

  No

  N/A

• Are suitable extinguishers available?

  Yes

  No

  N/A

11 Lightning

• Does the building have lightning protection system if required? (if yes has it been tested and are records of testing kept)

  Yes

  No

  N/A

12 Other significant ignition sources that warrant consideration

• List other ignition sources:

13 Housekeeping

• Is the standard of housekeeping adequate?

  Yes

  No

  N/A

• Are combustible materials separated from ignition sources?

  Yes

  No

  N/A

• Is the unnecessary accumulation of combustibles and waste avoided?

  Yes

  No

  N/A

• Is there appropriate storage of hazardous materials?

  Yes

  No

  N/A

• Are combustible materials stored appropriately?

  Yes

  No

  N/A

14 Hazards introduced by contractors and building works

• Is there sufficient control over works by contractors (e.g. Permits to work & hot works permits)?

  Yes

  No

  N/A

• Are there arrangements for the safe storage of gas bottles and others hazardous materials

  Yes

  No

  N/A

• Are fire safety conditions and instructions communicated to contractors?

  Yes

  No

  N/A

15 Dangerous Substances

• Are dangerous substances present on the premises?

  Yes

  No

• Has the risk to relevant persons been adequately eliminated or reduced?

  Yes

  No

  N/A

Part 3: FIRE PROTECTION MEASURES

16 Means of escape

• Is the building provided with adequate means of escape in case of fire?

  Yes

  No

  N/A

• Are there sufficient exits?

  Yes

  No

  N/A

• Are exits easily and immediately openable where necessary?

  Yes

  No

  N/A

• Do fire exits open in the direction of travel where necessary?

  Yes

  No

  N/A

• Have sliding or revolving doors been avoided as fire exits?

  Yes

  No

  N/A

• Are there adequate means of securing exits?

  Yes

  No

  N/A

• Are there reasonable distances of travel where there is a single direction of travel?

  Yes

  No

  N/A

• Are there reasonable distances of travel where there are alternative means of escape?

  Yes

  No

  N/A

• Are escape routes adequately protected?

  Yes

  No

  N/A

• Are there suitable fire precautions for all inner rooms?

  Yes

  No

  N/A

• Are escape routes unobstructed?

  Yes

  No

  N/A

• Are there suitable means of escape for disabled occupants?

  Yes

  No

  N/A

17 Measures to limit fire spread and development.

• Is there a sufficient standard of compartmentation and sub-compartmentation?

  Yes

  No

  N/A

• Are linings that promote fire spread avoided as far as reasonably practicable?

  Yes

  No

  N/A

18 Escape lighting

• Is there a reasonable standard of escape lighting provided?

  Yes

  No

  N/A

19 Fire safety signs and notices

• Are fire safety signs and notices suitable and sufficient?

  Yes

  No

  N/A

20 Means of giving warning in the event of fire

• Is a manually operated electrical fire alarm system provided?

  Yes

  No

  N/A

• Is automatic fire detection provided?

  Yes

  No

  N/A

• Is there remote transmission of alarm signals?

  Yes

  No

  N/A

21 Manual fire extinguishing appliances

• Is there suitable and sufficient provision of portable fire extinguishers?

  Yes

  No

  N/A

• Are hose reels provided?

  Yes

  No

  N/A

22 Relevant automatic fire extinguishing systems

• Type of system:

• Comments and observations:

23 Facilities, equipment and devices for the protection of Fire-Fighters

• Types of facilities:

• Comments and observations:

Part 4: MANAGEMENT OF FIRE SAFETY

24 Procedures and arrangements

• Person responsible for fire safety:

• Are there competent persons available to assist in implementing fire safety arrangements?

  Yes

  No

  N/A

• Are appropriate fire procedures in place? (including arrangements for calling the fire service)

  Yes

  No

  N/A

• Fire Emergency Plan in place and details recorded?

  Yes

  No

  N/A

• Does the plan take account of other Fire Emergency Plans applicable in the building?

  Yes

  No

  N/A

• Is the Fire Emergency Plan readily available for staff to read?

  Yes

  No

  N/A

• Is the Fire Emergency Plan available to the enforcing authority?

  Yes

  No

  N/A

• Are there persons nominated to respond to fire?

  Yes

  No

  N/A

• Are persons nominated to assist with evacuation?

  Yes

  No

  N/A

• Is there appropriate liaison with the fire service?

  Yes

  No

  N/A

• Do routine in-house inspections of fire precautions take place?

  Yes

  No

  N/A

25 Training and drills

• Are staff given instruction on induction?

  Yes

  No

  N/A

• Do staff receive periodic refresher training at suitable intervals?

  Yes

  No

  N/A

• Are staff with special responsibilities given appropriate training?

  Yes

  No

  N/A

• Are fire drills carried out at appropriate intervals?

  Yes

  No

  N/A

26 Testing and maintenance

• Is the workplace adequately maintained?

  Yes

  No

  N/A

• Is there weekly testing and periodic servicing of the fire detection and alarm system?

  Yes

  No

  N/A

• Is there monthly, six-monthly and annual testing of the emergency lighting?

  Yes

  No

  N/A

• Is there annual maintenance and testing of fire extinguishing equipment?

  Yes

  No

  N/A

• Is there annual inspection and test of the lightning protection system?

  Yes

  No

  N/A

• Is there six monthly and annual testing of wet/dry risers?

  Yes

  No

  N/A

• Is there weekly testing and periodic inspection of sprinkler installations?

  Yes

  No

  N/A

• Is there routine checks of fire doors and final exit doors?

  Yes

  No

  N/A

• Other relevant inspection and test

27 Records

• Are there records of fire drills?

  Yes

  No

  N/A

• Are there records of fire training?

  Yes

  No

  N/A

• Are there records of fire alarm tests?

  Yes

  No

  N/A

• Are there records of emergency lighting tests?

  Yes

  No

  N/A

• Are there records of maintenance and testing of other fire protection systems?

  Yes

  No

  N/A

Part 5: RISK RATING AND RECOMMENDATIONS

Risk Items

• Item 1

• Probability (likelihood of fire)

  1 = Highly unlikely

  2 = Unlikely

  3 = Possible

  4 = Likely

  5 = Almost certain

• Consequence (impact on life safety)

  Select 1 = Minor injury (No 1st Aid) 2 = Minor injury (1st Aid) 3 = Injury (Dr/Hospital treatment) 4 = Major injury (Disability) 5 = Fatality

  • 1 = Minor injury (No 1st Aid)
  • 2 = Minor injury (1st Aid)
  • 3 = Injury (Dr/Hospital treatment)
  • 4 = Major injury (Disability)
  • 5 = Fatality

• Risk rating score (probability x consequence)

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

  • 1
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• Recommendations

• Action

• Item 2

• Probability (likelihood of fire)

  1 = Highly unlikely

  2 = Unlikely

  3 = Possible

  4 = Likely

  5 = Almost certain

• Consequence (impact on life safety)

  Select 1 = Minor injury (No 1st Aid) 2 = Minor injury (1st Aid) 3 = Injury (Dr/Hospital treatment) 4 = Major injury (Disability) 5 = Fatality

  • 1 = Minor injury (No 1st Aid)
  • 2 = Minor injury (1st Aid)
  • 3 = Injury (Dr/Hospital treatment)
  • 4 = Major injury (Disability)
  • 5 = Fatality

• Risk rating score (probability x consequence)

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

  • 1
  • 2
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• Recommendations

• Action

• Item 3

• Probability (likelihood of fire)

  1 = Highly unlikely

  2 = Unlikely

  3 = Possible

  4 = Likely

  5 = Almost certain

• Consequence (impact on life safety)

  Select 1 = Minor injury (No 1st Aid) 2 = Minor injury (1st Aid) 3 = Injury (Dr/Hospital treatment) 4 = Major injury (Disability) 5 = Fatality

  • 1 = Minor injury (No 1st Aid)
  • 2 = Minor injury (1st Aid)
  • 3 = Injury (Dr/Hospital treatment)
  • 4 = Major injury (Disability)
  • 5 = Fatality

• Risk rating score (probability x consequence)

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

  • 1
  • 2
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  • 5
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• Recommendations

• Action

• Item 4

• Probability (likelihood of fire)

  1 = Highly unlikely

  2 = Unlikely

  3 = Possible

  4 = Likely

  5 = Almost certain

• Consequence (impact on life safety)

  Select 1 = Minor injury (No 1st Aid) 2 = Minor injury (1st Aid) 3 = Injury (Dr/Hospital treatment) 4 = Major injury (Disability) 5 = Fatality

  • 1 = Minor injury (No 1st Aid)
  • 2 = Minor injury (1st Aid)
  • 3 = Injury (Dr/Hospital treatment)
  • 4 = Major injury (Disability)
  • 5 = Fatality

• Risk rating score (probability x consequence)

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

  • 1
  • 2
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  • 5
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• Recommendations

• Action

• Item 5

• Probability (likelihood of fire)

  1 = Highly unlikely

  2 = Unlikely

  3 = Possible

  4 = Likely

  5 = Almost certain

• Consequence (impact on life safety)

  Select 1 = Minor injury (No 1st Aid) 2 = Minor injury (1st Aid) 3 = Injury (Dr/Hospital treatment) 4 = Major injury (Disability) 5 = Fatality

  • 1 = Minor injury (No 1st Aid)
  • 2 = Minor injury (1st Aid)
  • 3 = Injury (Dr/Hospital treatment)
  • 4 = Major injury (Disability)
  • 5 = Fatality

• Risk rating score (probability x consequence)

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

  • 1
  • 2
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• Recommendations

• Action

• Item 6

• Probability (likelihood of fire)

  1 = Highly unlikely

  2 = Unlikely

  3 = Possible

  4 = Likely

  5 = Almost certain

• Consequence (impact on life safety)

  Select 1 = Minor injury (No 1st Aid) 2 = Minor injury (1st Aid) 3 = Injury (Dr/Hospital treatment) 4 = Major injury (Disability) 5 = Fatality

  • 1 = Minor injury (No 1st Aid)
  • 2 = Minor injury (1st Aid)
  • 3 = Injury (Dr/Hospital treatment)
  • 4 = Major injury (Disability)
  • 5 = Fatality

• Risk rating score (probability x consequence)

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

  • 1
  • 2
  • 3
  • 4
  • 5
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• Recommendations

• Action

• Item 7

• Probability (likelihood of fire)

  1 = Highly unlikely

  2 = Unlikely

  3 = Possible

  4 = Likely

  5 = Almost certain

• Consequence (impact on life safety)

  Select 1 = Minor injury (No 1st Aid) 2 = Minor injury (1st Aid) 3 = Injury (Dr/Hospital treatment) 4 = Major injury (Disability) 5 = Fatality

  • 1 = Minor injury (No 1st Aid)
  • 2 = Minor injury (1st Aid)
  • 3 = Injury (Dr/Hospital treatment)
  • 4 = Major injury (Disability)
  • 5 = Fatality

• Risk rating score (probability x consequence)

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

  • 1
  • 2
  • 3
  • 4
  • 5
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• Recommendations

• Action

• Item 8

• Probability (likelihood of fire)

  1 = Highly unlikely

  2 = Unlikely

  3 = Possible

  4 = Likely

  5 = Almost certain

• Consequence (impact on life safety)

  Select 1 = Minor injury (No 1st Aid) 2 = Minor injury (1st Aid) 3 = Injury (Dr/Hospital treatment) 4 = Major injury (Disability) 5 = Fatality

  • 1 = Minor injury (No 1st Aid)
  • 2 = Minor injury (1st Aid)
  • 3 = Injury (Dr/Hospital treatment)
  • 4 = Major injury (Disability)
  • 5 = Fatality

• Risk rating score (probability x consequence)

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
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• Recommendations

• Action

• Item 9

• Probability (likelihood of fire)

  1 = Highly unlikely

  2 = Unlikely

  3 = Possible

  4 = Likely

  5 = Almost certain

• Consequence (impact on life safety)

  Select 1 = Minor injury (No 1st Aid) 2 = Minor injury (1st Aid) 3 = Injury (Dr/Hospital treatment) 4 = Major injury (Disability) 5 = Fatality

  • 1 = Minor injury (No 1st Aid)
  • 2 = Minor injury (1st Aid)
  • 3 = Injury (Dr/Hospital treatment)
  • 4 = Major injury (Disability)
  • 5 = Fatality

• Risk rating score (probability x consequence)

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
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• Recommendations

• Action

• Item 10

• Probability (likelihood of fire)

  1 = Highly unlikely

  2 = Unlikely

  3 = Possible

  4 = Likely

  5 = Almost certain

• Consequence (impact on life safety)

  Select 1 = Minor injury (No 1st Aid) 2 = Minor injury (1st Aid) 3 = Injury (Dr/Hospital treatment) 4 = Major injury (Disability) 5 = Fatality

  • 1 = Minor injury (No 1st Aid)
  • 2 = Minor injury (1st Aid)
  • 3 = Injury (Dr/Hospital treatment)
  • 4 = Major injury (Disability)
  • 5 = Fatality

• Risk rating score (probability x consequence)

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
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• Recommendations

• Action

• Received by responsible person / representative

  Sign

• Assessor Signature

  Sign

• Pictures

  Media

Re-Assessment

• Recommended date for re-assessment

  Date