SHSC Fire Risk Assessment

• Ward / Area

• Person Attending

  Select

• Date of Previous Fire Risk Assessment

  Date

• Date of Fire Risk Assessment

  Date

• Suggested Date for Review

  Date

GENERAL INFORMATION

• Number of Floors

• Brief details about the construction

• Use of the premises

• The Occupants

• Approximate maximum number

• Number of Sleeping Occupants

• Number of Disabled Occupants

• Number of Elderly Occupants

HAZARD AND RISK FACTORS

• What are the factors present in the inspected area? You may choose multiple items. *You may also add photos, notes, and actions by clicking the paperclip icon.

  Select Smoking Cooking Electrical Portable Heaters Use of Candles Deliberate Ignition Alcohol or Drug Use Hoarding (Access) Oxygen Sensory Impairment Arson Housekeeping Dangerous Substances Other factors

  • Smoking
  • Cooking
  • Electrical
  • Portable Heaters
  • Use of Candles
  • Deliberate Ignition
  • Alcohol or Drug Use
  • Hoarding (Access)
  • Oxygen
  • Sensory Impairment
  • Arson
  • Housekeeping
  • Dangerous Substances
  • Other factors

Smoking

• Select a circumstance observed

  No signs of careless handling

  Has signs of careless handling

• Does not use reduced ignition propensity

  Yes

  No

• Discarded cigarettes and matches

  Yes

  No

• Found few burns on carpets

  Yes

  No

• Cigarette burns to clothes or furnishings

  Yes

  No

• Are there more details observed?

  Yes

  None
Detail

• Please provide further information here

Cooking

• Select a circumstance observed

  Select No evidence or suggestion of careless behavior Has evidence or suggestion of careless behavior

  • No evidence or suggestion of careless behavior
  • Has evidence or suggestion of careless behavior

• Inappropriate use of cooking equipment (e.g. microwave ovens).

  Yes

  No

• May occasionally leave cooking unattended.

  Yes

  No

• Likely to leave cooking unattended.

  Yes

  No

• History of alarm signals or small fires from cooking.

  Yes

  No

• Are there more details observed?

  Yes

  None
Detail

• Please provide further information here

Electrical

• Including equipment and extensive use of extension leads and adapters and/or electric blankets

• Select a circumstance observed

  Safe and maintained

  Adequately maintained

  Lack of maintenance

• Cube adapters used

  Yes

  No

• Potential overloading of circuits

  Yes

  No

• Worn equipment or cables

  Yes

  No

• REFERENCE: Extension cables in good working condition
  [This is an example of how you can use iAuditor to include best practice reference images in your templates to assist with inspections]
  

  

• Electric blankets not maintained regularly

  Yes

  No

• Are there more details observed?

  Yes

  None
Detail

• Please provide further information here

Portable Heaters

• Select a circumstance observed

  Select Compliant with modern standards (oil filled radiators or convector) Higher hazard (fan heaters, radiant bar fires)

  • Compliant with modern standards (oil filled radiators or convector)
  • Higher hazard (fan heaters, radiant bar fires)

• Evidence of heaters sited too close to combustible materials

  Yes

  None

• Likelihood of heaters sited too close to combustible materials

  Yes

  None

• Potential for other careless use (e.g. drying clothes, warming meals, etc.)

  Yes

  None

• Are there more details observed?

  Yes

  None
Detail

• Please provide further information here

Use of Candles

• Select a circumstance observed

  Select Used with appropriate precautions Used without appropriate precautions

  • Used with appropriate precautions
  • Used without appropriate precautions

• List further details of the current circumstance

Detail

• Please provide information here

Deliberate Ignition

• Select a circumstance observed

  Select No history or likely potential No history but has some potential Has history or potential

  • No history or likely potential
  • No history but has some potential
  • Has history or potential

• List further details of the current circumstance

• Previous history of deliberate ignition

  Yes

  No

• History of malicious false alarms to the fire and rescue service

  Yes

  No

• Are there more details observed?

  Yes

  None
Detail

• Please provide further information here

Alcohol or Drug Use

• Select a circumstance observed

  Select Without high fire risk behavior With high fire risk behavior

  • Without high fire risk behavior
  • With high fire risk behavior

• Evidence or likelihood of careless handling of smoking materials

  Yes

  No

• Evidence or likelihood of leaving cooking unattended

  Yes

  No

• Are there more details observed?

  Yes

  None
Detail

• Please provide further information here

Hoarding (access)

• Select a circumstance observed

  Select No hoarding, or hoarding of generally non-combustible materials that do not obstruct escape routes Hoarding between clutter levels 1 and 413

  • No hoarding, or hoarding of generally non-combustible materials that do not obstruct escape routes
  • Hoarding between clutter levels 1 and 413

• Hoarding confined to a single room

  Yes

  No

• Hoarding in more than one room

  Yes

  No

• Hoarding within escape route

  Yes

  No

• List the types of materials hoarded

Material

• Please specify

Oxygen

• Use of oxygen combined with high fire risk behavior

  Yes

  No

• Are there other details observed?

  Yes

  No
Detail

• Provide further information here

Sensory Impairment

• Select a circumstance observed

  Select Hard of hearing, or partially sighted Deaf or blind

  • Hard of hearing, or partially sighted
  • Deaf or blind

• Please specify further details observed

Detail

• Provide information here

Arson

• Select a circumstance observed

  Very secured

  Has reasonable security

  No security at all

• Are there fire loads in close proximity from the premise?

  Yes

  No

• Are there more details observed?

  Yes

  None
Detail

• Provide further information here

Housekeeping

• Select a circumstance observed

  Adequate

  Inadequate

• Combustible materials appear to be unseparated from ignition sources

  Yes

  No

• No appropriate storage of hazardous materials

  Yes

  No

• Inappropriate storage of Combustible materials

  Yes

  No

• Are there more details observed?

  Yes

  None
Detail

• Provide further information here

Dangerous Substances

• Select a circumstance observed

  Select Stored and used with precaution Not stored properly

  • Stored and used with precaution
  • Not stored properly

• List observations

Other Factors

• Please list factors not mentioned above and provide further details to each.

Risk Factor

• State them here

FIRE PROTECTION MEASURES

• 1. Means of Escape from Fire

• It is considered that the premises are provided with reasonable means of escape in case of fire

  Yes

  No

  N/A

• Has adequate design of escape routes?

  Yes

  No

  N/A

• Has adequate provision of exits?

  Yes

  No

  N/A

• Exits easily and immediately openable where necessary?

  Yes

  No

  N/A

• Fire exits open in direction of escape where necessary?

  Yes

  No

  N/A

• Avoidance of sliding or revolving doors as fire exits where necessary?

  Yes

  No

  N/A

• Satisfactory means for securing exits?

  Yes

  No

  N/A

• Has alternative means of escape?

  Yes

  No

  N/A

• Escape routes unobstructed?

  Yes

  No

  N/A

• It is considered that the premises are provided with reasonable arrangements for means of escape for disabled people.

  Yes

  No

  N/A

• 2. Emergency Escape Lighting

• Has reasonable standard of emergency escape lighting provided?

  Yes

  No

  N/A

• Fire Safety Signs and Notices

• Has reasonable standard of fire safety signs and notices?

  Yes

  No

  N/A

• 3. Means of Giving Warning in case of Fire

• Has reasonable manually operated electrical fire alarm system provided?

  Yes

  No

  N/A

• Has automatic fire detection provided?

  Yes

  No

  N/A

• Has remote transmission of alarm signals?

  Yes

  No

  N/A

• 4. Manual Fire Extinguishing Appliances

• Has reasonable provision of portable fire extinguishers?

  Yes

  No

  N/A

• Hose reels provided?

  Yes

  No

  N/A

• Are all fire extinguishing appliances readily accessible?

  Yes

  No

  N/A

• 5. Procedures and Arrangements

• Are procedures in the event of fire appropriate and properly documented?

  Yes

  No

  N/A

• Are there suitable arrangements for Summoning the fire and rescue service?

  Yes

  No

  N/A

• Are there suitable arrangements to meet provide relevant information, including that related to hazards to firefighters?

  Yes

  No

  N/A

• Are there suitable arrangements for ensuring that the premises have been evacuated?

  Yes

  No

  N/A

• Is there a suitable fire assembly point(s)?

  Yes

  No

  N/A

• Are there adequate procedures for evacuation of any disabled people who are likely to be to be present?

  Yes

  No

  N/A

• Persons nominated and trained to use fire extinguishing appliances?

  Yes

  No

  N/A

• Persons nominated and trained to assist with evacuation, including the evacuation of disabled people?

  Yes

  No

  N/A

• 6. Training and Drills

• Are all staff/members given adequate fire safety instruction and training?

  Yes

  No

  N/A

• Which of these items do the members or staff knowledgeable about? You may select multiple items.

  Select Fire risks Fire safety measures Action in the event of a fire Action on hearing the fire alarm signal Method of operation of manual call points Location and use of fire extinguishers Means for summoning the fire and rescue service Identity of persons nominated to assist with evacuation Fire drills

  • Fire risks
  • Fire safety measures
  • Action in the event of a fire
  • Action on hearing the fire alarm signal
  • Method of operation of manual call points
  • Location and use of fire extinguishers
  • Means for summoning the fire and rescue service
  • Identity of persons nominated to assist with evacuation
  • Fire drills

• 7. Testing and Maintenance

• Has adequate maintenance of premises?

  Yes

  No

  N/A

• Has weekly testing and periodic servicing of fire detection and alarm system?

  Yes

  No

  N/A

• Has monthly and annual testing routines for emergency escape lighting?

  Yes

  No

  N/A

• Has annual maintenance of fire extinguishing appliances?

  Yes

  No

  N/A

• Has periodic inspection of external escape staircases and gangways?

  Yes

  No

  N/A

• Has weekly and monthly testing, six monthly inspections and annual testing of firefighting lifts?

  Yes

  No

  N/A

• Has weekly testing and periodic inspection of sprinkler installations?

  Yes

  No

  N/A

• Has routine checks of final exit doors and/or security fastenings?

  Yes

  No

  N/A

• Has annual inspection and testing of lightning protection system?

  Yes

  No

  N/A

• 8. Records
  Appropriate records of:

• Fire drills?

  Yes

  No

  N/A

• Fire training?

  Yes

  No

  N/A

• Fire alarm tests?

  Yes

  No

  N/A

• Emergency escape lighting tests?

  Yes

  No

  N/A

• Maintenance and testing of other fire protection Systems?

  Yes

  No

  N/A

• The following simple fire risk level estimator is based on a commonly used health and safety risk level estimator.

• 

• DEFINITION OF TERMS (Risk from Fire)

• 

• Taking into account the fire prevention measures observed at the time of this risk assessment, it is considered that the risk from fire (likelihood of fire) at these premises is:

  LOW

  MEDIUM

  HIGH

• DEFINITION OF TERMS (Risk Assessment)

• 

• Taking into account the nature of the premises and the occupants, as well as the fire protection and procedural arrangements observed at the time of this fire risk assessment, it is considered that the consequences for life safety in the event of fire would be:

  SLIGHT HARM

  MODERATE HARM

  EXTREME HARM

• DEFINITION OF TERMS (Risk Level)

• 

• Accordingly, it is considered that the risk to life from fire at these premises is:

  Trivial

  Tolerable

  Moderate

  Substantial

  Intolerable

COMPLETION

• Name of Responsible Person and Signature

  Sign

• Assessor's Name and Signature

  Sign