Title Page
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Building / Site & Location
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Date of visit
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HE Regional FM staff
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FM Service Provider
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E&F Senior Manager
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Service Delivery
Second Floor
Roof Access Room 2nd Floor Right Stairs
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First Floor
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Room Secured
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Lighting
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Walls, floor & ceiling
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Warning signage
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Doors (inc fire signage)
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Door Smoke seals
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Storage issues
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Cleaning
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Fire stopping
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Ladder
Corridor 2nd Floor
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Lighting
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Walls, floor & ceiling
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Fire Exit signage
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Doors (inc fire signage)
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Smoke seals
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Closers
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Storage issues
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Cleaning
OMS office 2nd Floor
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Lighting
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HVAC
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Cable Management
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PAT Items and date
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Window, walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Water Cooler
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Condition of furniture
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Cleaning
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Fire Extinguishers In place
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Date of test
Service Delivery office 2nd Floor
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Lighting
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HVAC
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Cable Management
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PAT Items and date
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Windows, walls, floor & ceiling
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Storage issues
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Water Cooler
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Condition of furniture
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Furniture layout
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Cleaning
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Fire Extinguishers In place
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Date of test
undefined
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Lighting
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HVAC
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Cable Management
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Windows, walls, floor & ceiling
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PAT Items and date
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Doors (inc fire signage)
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Smoke seals
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Closers
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Storage issues
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Water Cooler
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Condition of furniture
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Cleaning
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Fire Extinguishers In place
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Date of test
Emergency Planning office 2nd Floor
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Lighting
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HVAC
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Cable Management
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Windows, walls, floor & ceiling
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PAT Items and date
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Doors (inc fire signage)
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Smoke seals
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Closers
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Storage issues
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Water Cooler
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Condition of furniture
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Cleaning
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Fire Extinguishers In place
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Date of test
Meeting Room Zero 2nd Floor
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Lighting
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HVAC
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Cable Management
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PAT Items and date
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Notices and Notice Board
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Windows, walls, floor ceiling
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Storage issues
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Doors (inc fire signage)
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Smoke seals
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Closers
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Condition of furniture
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Water Cooler
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Cleaning
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Fire Extinguishers In place
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Date of test
Locker Room 2nd Floor (Storeroom 3)
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Lighting
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Heating Radiator
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Walls, floor & ceiling
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Doors (inc fire signage)
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Smoke seals
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Closers
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Doors (inc fire signage)
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Door smoke seals
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Storage issues
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Condition of furniture
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Comments
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Photo
Storeroom 2 - 2nd Floor
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Cleaning
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Comments
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Lighting
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Walls, floor & ceiling
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Doors (inc fire signage)
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Smoke seals
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Storage issues
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Condition of furniture
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Cleaning
Rest Room - 2nd Floor
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Lighting
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Heating Radiator
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Cable Management
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Windows, walls, floor & ceiling
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Doors (inc fire signage)
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Smoke seals
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Closers
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Storage issues
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Condition of furniture
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Cleaning
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Notice Board
First Aid Room 2nd Floor
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Lighting
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Heating radiator
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Windows, walls, floor ceiling
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Doors (inc fire signage)
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Smoke seals
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Closers
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Storage issues
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Condition of Bed
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Condition of Sink
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Cleaning
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First Aid Kit checked
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Date
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Sharps bin in place and empty
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Defibrillator test and battery and pads in date
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First Aid supplies inc Bedding
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Date
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Health and Safety Notices
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PAT Items
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Date
Storeroom 1 - 2nd Floor
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Lighting
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Heating Radiator
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Walls, floor ceiling
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Doors (inc fire signage)
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Smoke seals
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Storage issues
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Condition of furniture
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Cleaning
Shower Room - 2nd Floor
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Lighting
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Radiator and Extract Fan
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Walls, floor & ceiling
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Shower and Shower head clean
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Doors (inc fire signage)
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Smoke seals
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Closers
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Storage issues
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Condition of fittings inc Seating
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Cleaning
Ladies Toilet - 2nd Floor
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Lighting
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Heating and Extract Fan
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Windows, walls, floor & ceiling
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Doors (inc fire signage)
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Smoke seals
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Closers
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Condition of fittings
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Cleaning
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Hand dryers
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Tap condition/scale
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Air fresheners
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Sanitary Bins
Gents Toilet - 2nd Floor
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Lighting
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Heating and Extract Fan
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Windows, walls, floor & ceiling
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Doors (inc fire signage)
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Smoke seals
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Closers
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Condition of fittings
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Cleaning
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Hand dryers
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Tap condition/scale
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Air fresheners
Disabled Toilet - 2nd Floor
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Lighting
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Radiator and Extract Fan
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Condition of fittings
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Cleaning
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Toilet Tap & sink condition/scale
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Cleaners Tap & sink condition/scale
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Hand dryers
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Air fresheners
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Sanitary Bins
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Disabled assistance alarm
Kitchen - 2nd Floor
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Lighting
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Cooker Extract Fans x 2
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Condition of fittings
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Cleaning
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Bins
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Fridge/freezer
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Water Boiler condition/Tap scale
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Microwave x condition
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Date of test
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PAT Items
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Date
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Tap scale/Sink condition x 2
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Fire Blankets x 2
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Fire Extinguishers in place
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Date of test
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First Aid Kit
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Date
Lift Lobby 2nd Floor
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Lighting
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Signage by lift
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Cleaning
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Fire Extinguishers In place
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Date of test
First Floor
Lift Lobby 1st Floor
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Lighting
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Signage by lift
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Cleaning
Silver Command office 1st Floor
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Lighting
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HVAC
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Cable Management
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PAT Items
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Date
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Windows, walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Condition of furniture
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Cleaning
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Access control
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Denco Riser in Silver Command
Briefing Area 1st Floor
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Lighting
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Walls, floor & ceiling
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Storage issues
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Cleaning
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Fire Extinguishers In place
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Date of test
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Notices and Notice Board
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Seating
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Vending
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Water Cooler
Meeting Room 1 - 1st Floor
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Lighting
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HVAC
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Cable Management
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PAT Items and date
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Windows, walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Water Cooler
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Coffee Machine
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Condition of furniture
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Cleaning
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Storeroom (Service Delivery)
Meeting Room 2 - 1st Floor
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Lighting
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HVAC
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Cable Management
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PAT Items and date
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Windows, walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Condition of furniture
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Cleaning
TM Room - 1st Floor
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Lighting
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HVAC
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Cable Management
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PAT Items and date
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Windows, walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Condition of furniture
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Cleaning
Control Room - 1st Floor
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Lighting
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HVAC
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Cable Management
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PAT Items and date
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Windows, walls, floor & ceiling
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Doors (inc fire signage)
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First Aid box
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Door Smoke seals
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Door Closers
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Storage issues
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Water Cooler
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Condition of furniture
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Cleaning
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Fire Extinguishers In place
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Date of test
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Access control x 3 doors
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Elec Riser
DDS Room - 1st Floor
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Lighting
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HVAC
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Cable Management
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Windows, walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Condition of furniture
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Cleaning
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Ladder
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Fire Extinguishers In place
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Date of test
Hot Desk Room - 1st Floor
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Lighting
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HVAC
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Cable Management
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PAT Items and date
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Windows, walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Condition of furniture
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Cleaning
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Fire Extinguishers In place
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Date of test
Cleaner Store 1st Floor Right Stairs
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Room Secured
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Lighting
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Storage issues
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Cleaning
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Vacuum
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Fire stopping
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COSHH Register and chemicals stored correctly. Bunded
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Health & Safety Notices
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H&S signage on door.
Ground Floor
Lift Lobby Ground Floor
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Lighting
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Walls, floor & ceiling
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Storage issues
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H&S Signage by lift
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Cleaning
Cleaner Locker Room Ground Floor
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Lighting
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Radiator & Extract
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Walls, floor & ceiling
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Storage issues
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Cleaning
Gents Toilet - Ground Floor
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Lighting
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Heating and Extract Fan
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Condition of fittings
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Cleaning
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Hand dryers
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Tap condition/scale
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Air fresheners
Ladies Toilet – Ground Floor
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Lighting
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Heating and Extract Fan
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Condition of fittings
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Cleaning
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Hand dryers
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Tap condition/scale
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Air fresheners
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Sanitary Bins
Disabled Toilet – Ground Floor
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Lighting
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Heating and Extract Fan
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Storage issues
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Condition of fittings
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Cleaning
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Tap condition/scale
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Hand dryers
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Air fresheners
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Sanitary Bins
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Disabled assistance alarm
FM Storeroom Ground Floor
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Lighting
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Condition of fittings
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Ladders
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Cleaning
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Fire Extinguishers In place
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Date of test
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H&S signage
Meeting Room 3 Ground Floor
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Lighting
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HVAC
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Extract
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Cable Management
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PAT Items
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Date
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Notices and Notice Board H&S
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Walls, floor ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Condition of furniture
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Coffee Machine
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Water Cooler
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Cleaning
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Fire Extinguishers In place
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Date of test
Server/Equipment Room Ground Floor
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Lighting
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HVAC
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Extract
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Cable Management
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PAT Items and date
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Notices and Notice Board H&S
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Walls, floor ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Condition of Equipment
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Cleaning
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Fire Extinguishers In place
- Yes
- No
- N/A
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Date of test
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Fire Suppression System
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Cylinder dates
UPS Room Ground Floor
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Lighting
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HVAC
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Extract
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Walls, floor ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Condition of Equipment
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Cleaning
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Fire Extinguishers In place
- Yes
- No
- N/A
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Date of test
IT Storeroom (Next to UPS Room) Ground Floor Right Stairs
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Room Secured
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Lighting
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Cable Management
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Storage issues
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Cleaning
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Fire stopping
Storeroom Basement Right Stairs by Fire Exit
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Room Secured
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Lighting
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Storage issues
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Cleaning
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Fire stopping
Engineers Office Ground Floor
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Lighting
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HVAC
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Cable Management
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PAT Items
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Date
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Walls, floor ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Condition of Equipment
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Cleaning
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Water Cooler
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First Aid Kit
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Date
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Fire Extinguishers In place
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Date of test
Facilities Office Ground Floor
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Lighting
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HVAC
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Cable Management
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PAT Items and date
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Walls, floor ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door Closers
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Storage issues
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Condition of Equipment
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Fridge
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Cleaning
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Access Control/CCTV
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BMS
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Fire Alarm Panel
Reception Ground Floor
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Lighting
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Cable Management
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Walls, floor ceiling
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Doors (inc fire signage)
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Door Smoke seals
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Door closers
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Storage issues
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Condition of Equipment
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Defibrillator test and battery and pads in date
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Cleaning
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Fire Extinguishers In place
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Date of test
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Fire Alarm Panel
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H&S Signage
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Notice Board
Boiler Room Ground Floor
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Maintenance and Testing
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Room Secure
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Lighting
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Extract system
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Cable Management
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Walls, floor & ceiling
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Doors (inc fire signage)
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Storage issues
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Cleaning
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Fire Extinguishers In place
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Date of test
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Safety signage
Basement
Cleaner Store Basement Left Stairs
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Room Secured
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Lighting
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door smoke seals
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Storage issues
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Cleaning
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Fire stopping
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Health & Safety Notices
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H&S signage on door.
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COSHH Register and chemicals stored correctly, Bunded
Lift Motor Room Basement
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Room Secured
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Lighting
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Cable Management
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door smoke seals
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Storage issues
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Cleaning
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Fire Extinguishers In place
-
Date of test
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Fire stopping
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Health & Safety Notices
Car Park Basement
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Lighting
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Extract system
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Cable Management
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Walls, floor & ceiling
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Drainage
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Shutter
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Line Marking
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Fire Exit Routes
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Doors (inc fire signage)
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Door smoke seals
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Door closers
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Storage issues
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Cleaning
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Fire Extinguishers In place
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Date of test
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Fire stopping
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Water and Hose
Generator Basement
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Maintenance and Testing
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Room Secure
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Lighting
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Extract system
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Cable Management
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Walls, floor & ceiling
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Doors (inc fire signage)
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Storage issues
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Cleaning
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Fire Extinguishers In place
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Date of test
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Safety signage
Electric Risers Basement x 3
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Maintenance and Testing
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Doors Secured
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Cable Management
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door smoke seals
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Storage issues
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Fire Stopping
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Safety signage
Storeroom Basement (Service Delivery)
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Lighting
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Walls, floor & ceiling
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Doors (inc fire signage)
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Door smoke seals
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Storage issues
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Condition of fittings
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Cleaning
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H&S signage
Exterior & All Floors
Exterior
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Grounds Maintenance
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Cleaning
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Carpark Management Vehicle segregation/ line marking
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Exterior Building Fabric
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Safety signage
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Paths/Walkways
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Rear Gate Secured
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Walls/Fencing
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Gates/Barriers
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Lighting
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Roofs
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Water/Drainage
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Bins
All Floors
Staircase Main Left-Hand side
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Lighting ok
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Carpets and stair treads
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Cleaning
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Widows
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Fire Exit signage
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Fire Extinguishers In place
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Date of test
Staircase Right Hand side
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Lighting ok
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Carpets and stair treads
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Cleaning
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Windows
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Fire Exit signage
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Fire Extinguishers In place
-
Date of test
Sign-off
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Completed by
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Date