Title Page

  • Building / Site & Location

  • Date of visit

  • HE Regional FM staff

  • FM Service Provider

  • E&F Senior Manager

  • Service Delivery

Second Floor

Roof Access Room 2nd Floor Right Stairs

  • First Floor

  • Room Secured

  • Lighting

  • Walls, floor & ceiling

  • Warning signage

  • Doors (inc fire signage)

  • Door Smoke seals

  • Storage issues

  • Cleaning

  • Fire stopping

  • Ladder

Corridor 2nd Floor

  • Lighting

  • Walls, floor & ceiling

  • Fire Exit signage

  • Doors (inc fire signage)

  • Smoke seals

  • Closers

  • Storage issues

  • Cleaning

OMS office 2nd Floor

  • Lighting

  • HVAC

  • Cable Management

  • PAT Items and date

  • Window, walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Water Cooler

  • Condition of furniture

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

Service Delivery office 2nd Floor

  • Lighting

  • HVAC

  • Cable Management

  • PAT Items and date

  • Windows, walls, floor & ceiling

  • Storage issues

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Water Cooler

  • Condition of furniture

  • Furniture layout

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

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  • Lighting

  • HVAC

  • Cable Management

  • Windows, walls, floor & ceiling

  • PAT Items and date

  • Doors (inc fire signage)

  • Smoke seals

  • Closers

  • Storage issues

  • Water Cooler

  • Condition of furniture

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

Emergency Planning office 2nd Floor

  • Lighting

  • HVAC

  • Cable Management

  • Windows, walls, floor & ceiling

  • PAT Items and date

  • Doors (inc fire signage)

  • Smoke seals

  • Closers

  • Storage issues

  • Water Cooler

  • Condition of furniture

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

Meeting Room Zero 2nd Floor

  • Lighting

  • HVAC

  • Cable Management

  • PAT Items and date

  • Notices and Notice Board

  • Windows, walls, floor ceiling

  • Storage issues

  • Doors (inc fire signage)

  • Smoke seals

  • Closers

  • Condition of furniture

  • Water Cooler

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

Locker Room 2nd Floor (Storeroom 3)

  • Lighting

  • Heating Radiator

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Smoke seals

  • Closers

  • Doors (inc fire signage)

  • Door smoke seals

  • Storage issues

  • Condition of furniture

  • Comments

  • Photo

Storeroom 2 - 2nd Floor

  • Cleaning

  • Comments

  • Lighting

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Smoke seals

  • Storage issues

  • Condition of furniture

  • Cleaning

Rest Room - 2nd Floor

  • Lighting

  • Heating Radiator

  • Cable Management

  • Windows, walls, floor & ceiling

  • Doors (inc fire signage)

  • Smoke seals

  • Closers

  • Storage issues

  • Condition of furniture

  • Cleaning

  • Notice Board

First Aid Room 2nd Floor

  • Lighting

  • Heating radiator

  • Windows, walls, floor ceiling

  • Doors (inc fire signage)

  • Smoke seals

  • Closers

  • Storage issues

  • Condition of Bed

  • Condition of Sink

  • Cleaning

  • First Aid Kit checked

  • Date

  • Sharps bin in place and empty

  • Defibrillator test and battery and pads in date

  • First Aid supplies inc Bedding

  • Date

  • Health and Safety Notices

  • PAT Items

  • Date

Storeroom 1 - 2nd Floor

  • Lighting

  • Heating Radiator

  • Walls, floor ceiling

  • Doors (inc fire signage)

  • Smoke seals

  • Storage issues

  • Condition of furniture

  • Cleaning

Shower Room - 2nd Floor

  • Lighting

  • Radiator and Extract Fan

  • Walls, floor & ceiling

  • Shower and Shower head clean

  • Doors (inc fire signage)

  • Smoke seals

  • Closers

  • Storage issues

  • Condition of fittings inc Seating

  • Cleaning

Ladies Toilet - 2nd Floor

  • Lighting

  • Heating and Extract Fan

  • Windows, walls, floor & ceiling

  • Doors (inc fire signage)

  • Smoke seals

  • Closers

  • Condition of fittings

  • Cleaning

  • Hand dryers

  • Tap condition/scale

  • Air fresheners

  • Sanitary Bins

Gents Toilet - 2nd Floor

  • Lighting

  • Heating and Extract Fan

  • Windows, walls, floor & ceiling

  • Doors (inc fire signage)

  • Smoke seals

  • Closers

  • Condition of fittings

  • Cleaning

  • Hand dryers

  • Tap condition/scale

  • Air fresheners

Disabled Toilet - 2nd Floor

  • Lighting

  • Radiator and Extract Fan

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Condition of fittings

  • Cleaning

  • Toilet Tap & sink condition/scale

  • Cleaners Tap & sink condition/scale

  • Hand dryers

  • Air fresheners

  • Sanitary Bins

  • Disabled assistance alarm

Kitchen - 2nd Floor

  • Lighting

  • Cooker Extract Fans x 2

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Condition of fittings

  • Cleaning

  • Bins

  • Fridge/freezer

  • Water Boiler condition/Tap scale

  • Microwave x condition

  • Date of test

  • PAT Items

  • Date

  • Tap scale/Sink condition x 2

  • Fire Blankets x 2

  • Fire Extinguishers in place

  • Date of test

  • First Aid Kit

  • Date

Lift Lobby 2nd Floor

  • Lighting

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Signage by lift

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

First Floor

Lift Lobby 1st Floor

  • Lighting

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Signage by lift

  • Cleaning

Silver Command office 1st Floor

  • Lighting

  • HVAC

  • Cable Management

  • PAT Items

  • Date

  • Windows, walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Condition of furniture

  • Cleaning

  • Access control

  • Denco Riser in Silver Command

Briefing Area 1st Floor

  • Lighting

  • Walls, floor & ceiling

  • Storage issues

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

  • Notices and Notice Board

  • Seating

  • Vending

  • Water Cooler

Meeting Room 1 - 1st Floor

  • Lighting

  • HVAC

  • Cable Management

  • PAT Items and date

  • Windows, walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Water Cooler

  • Coffee Machine

  • Condition of furniture

  • Cleaning

  • Storeroom (Service Delivery)

Meeting Room 2 - 1st Floor

  • Lighting

  • HVAC

  • Cable Management

  • PAT Items and date

  • Windows, walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Condition of furniture

  • Cleaning

TM Room - 1st Floor

  • Lighting

  • HVAC

  • Cable Management

  • PAT Items and date

  • Windows, walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Condition of furniture

  • Cleaning

Control Room - 1st Floor

  • Lighting

  • HVAC

  • Cable Management

  • PAT Items and date

  • Windows, walls, floor & ceiling

  • Doors (inc fire signage)

  • First Aid box

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Water Cooler

  • Condition of furniture

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

  • Access control x 3 doors

  • Elec Riser

DDS Room - 1st Floor

  • Lighting

  • HVAC

  • Cable Management

  • Windows, walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Condition of furniture

  • Cleaning

  • Ladder

  • Fire Extinguishers In place

  • Date of test

Hot Desk Room - 1st Floor

  • Lighting

  • HVAC

  • Cable Management

  • PAT Items and date

  • Windows, walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Condition of furniture

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

Cleaner Store 1st Floor Right Stairs

  • Room Secured

  • Lighting

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Storage issues

  • Cleaning

  • Vacuum

  • Fire stopping

  • COSHH Register and chemicals stored correctly. Bunded

  • Health & Safety Notices

  • H&S signage on door.

Ground Floor

Lift Lobby Ground Floor

  • Lighting

  • Walls, floor & ceiling

  • Storage issues

  • H&S Signage by lift

  • Cleaning

Cleaner Locker Room Ground Floor

  • Lighting

  • Radiator & Extract

  • Walls, floor & ceiling

  • Storage issues

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Cleaning

Gents Toilet - Ground Floor

  • Lighting

  • Heating and Extract Fan

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Condition of fittings

  • Cleaning

  • Hand dryers

  • Tap condition/scale

  • Air fresheners

Ladies Toilet – Ground Floor

  • Lighting

  • Heating and Extract Fan

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Condition of fittings

  • Cleaning

  • Hand dryers

  • Tap condition/scale

  • Air fresheners

  • Sanitary Bins

Disabled Toilet – Ground Floor

  • Lighting

  • Heating and Extract Fan

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Storage issues

  • Condition of fittings

  • Cleaning

  • Tap condition/scale

  • Hand dryers

  • Air fresheners

  • Sanitary Bins

  • Disabled assistance alarm

FM Storeroom Ground Floor

  • Lighting

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Condition of fittings

  • Ladders

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

  • H&S signage

Meeting Room 3 Ground Floor

  • Lighting

  • HVAC

  • Extract

  • Cable Management

  • PAT Items

  • Date

  • Notices and Notice Board H&S

  • Walls, floor ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Condition of furniture

  • Coffee Machine

  • Water Cooler

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

Server/Equipment Room Ground Floor

  • Lighting

  • HVAC

  • Extract

  • Cable Management

  • PAT Items and date

  • Notices and Notice Board H&S

  • Walls, floor ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Condition of Equipment

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

  • Fire Suppression System

  • Cylinder dates

UPS Room Ground Floor

  • Lighting

  • HVAC

  • Extract

  • Walls, floor ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Condition of Equipment

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

IT Storeroom (Next to UPS Room) Ground Floor Right Stairs

  • Room Secured

  • Lighting

  • Cable Management

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Storage issues

  • Cleaning

  • Fire stopping

Storeroom Basement Right Stairs by Fire Exit

  • Room Secured

  • Lighting

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Storage issues

  • Cleaning

  • Fire stopping

Engineers Office Ground Floor

  • Lighting

  • HVAC

  • Cable Management

  • PAT Items

  • Date

  • Walls, floor ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Condition of Equipment

  • Cleaning

  • Water Cooler

  • First Aid Kit

  • Date

  • Fire Extinguishers In place

  • Date of test

Facilities Office Ground Floor

  • Lighting

  • HVAC

  • Cable Management

  • PAT Items and date

  • Walls, floor ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door Closers

  • Storage issues

  • Condition of Equipment

  • Fridge

  • Cleaning

  • Access Control/CCTV

  • BMS

  • Fire Alarm Panel

Reception Ground Floor

  • Lighting

  • Cable Management

  • Walls, floor ceiling

  • Doors (inc fire signage)

  • Door Smoke seals

  • Door closers

  • Storage issues

  • Condition of Equipment

  • Defibrillator test and battery and pads in date

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

  • Fire Alarm Panel

  • H&S Signage

  • Notice Board

Boiler Room Ground Floor

  • Maintenance and Testing

  • Room Secure

  • Lighting

  • Extract system

  • Cable Management

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Storage issues

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

  • Safety signage

Basement

Cleaner Store Basement Left Stairs

  • Room Secured

  • Lighting

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door smoke seals

  • Storage issues

  • Cleaning

  • Fire stopping

  • Health & Safety Notices

  • H&S signage on door.

  • COSHH Register and chemicals stored correctly, Bunded

Lift Motor Room Basement

  • Room Secured

  • Lighting

  • Cable Management

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door smoke seals

  • Storage issues

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

  • Fire stopping

  • Health & Safety Notices

Car Park Basement

  • Lighting

  • Extract system

  • Cable Management

  • Walls, floor & ceiling

  • Drainage

  • Shutter

  • Line Marking

  • Fire Exit Routes

  • Doors (inc fire signage)

  • Door smoke seals

  • Door closers

  • Storage issues

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

  • Fire stopping

  • Water and Hose

Generator Basement

  • Maintenance and Testing

  • Room Secure

  • Lighting

  • Extract system

  • Cable Management

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Storage issues

  • Cleaning

  • Fire Extinguishers In place

  • Date of test

  • Safety signage

Electric Risers Basement x 3

  • Maintenance and Testing

  • Doors Secured

  • Cable Management

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door smoke seals

  • Storage issues

  • Fire Stopping

  • Safety signage

Storeroom Basement (Service Delivery)

  • Lighting

  • Walls, floor & ceiling

  • Doors (inc fire signage)

  • Door smoke seals

  • Storage issues

  • Condition of fittings

  • Cleaning

  • H&S signage

Exterior & All Floors

Exterior

  • Grounds Maintenance

  • Cleaning

  • Carpark Management Vehicle segregation/ line marking

  • Exterior Building Fabric

  • Safety signage

  • Paths/Walkways

  • Rear Gate Secured

  • Walls/Fencing

  • Gates/Barriers

  • Lighting

  • Roofs

  • Water/Drainage

  • Bins

All Floors

Staircase Main Left-Hand side

  • Lighting ok

  • Carpets and stair treads

  • Cleaning

  • Widows

  • Fire Exit signage

  • Fire Extinguishers In place

  • Date of test

Staircase Right Hand side

  • Lighting ok

  • Carpets and stair treads

  • Cleaning

  • Windows

  • Fire Exit signage

  • Fire Extinguishers In place

  • Date of test

Sign-off

  • Completed by

  • Date

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.