Summary of Activities: Please provide brief details of the activities carried out on site

Staff Information:

Normal No. of Staff regularly working on site during normal working hours:

Normal No. of staff working on site during out-of-hours times:

Maximum No. of Staff on site during normal working hours (Estimate as necessary):

Maximum No. of staff working on site during out-of-hours times:

Do you have any staff who require a Personal Emergency Evacuation Plan (PEEP)?

Have the PEEP(s) been reviewed within the last 12 months?

Have all staff completed Fire Safety Training as per the organisation’s Fire Policy?

Has your organisation nominated Fire Marshals for the area you occupy?

When was the last Fire Evacuation Drill carried out involving your staff?
Patient Information:

Do you have In-patient Facilities?

Please provide details of In-patients facilities - Total No. Beds

Average No. occupied

Do In-patients need assistance to evacuate?

Do you have out-patients?

Do out-patients need assistance to evacuate?

Please provide any other patient-related information that may be relevant in the event of an evacuation:

Is there any Dangerous Substances/ Environmental Risks?

Item - Quantity - Brief Usage and - Date of COSHH Assessment

Fire Hazards relating to your Organisation

Have Portable Appliances been tested within the last 12 months (spot check)?

Have COSHH assessments been completed for all relevant substances?

Does this identify any other Fire Hazards that have not previously been covered?

If ‘Yes’, provide details below and attach your action plan:

Fire Policy

Does your organisation have a Fire Policy?

Do your activities follow the requirements laid down by your Fire Policy?

If No, provide details:

Please provide details of any other activities or information relevant to Fire Safety:

As a tenant in a multi-occupied site, our organisation agrees to:

Adopt the Landlord’s Fire Risk Assessment assessing the Fire risks relating to the fabric of the building

Action any findings required as a result of the Landlord’s Fire Risk Assessment

Ensure that operational changes are risk assessed for Fire and the Landlord is informed, as necessary to allow the Fire Risk Assessment can be updated

Ensure Fire-related Risk Assessment(s) are carried out for any specific hazards/ activities identified

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Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.