Information

  • Tenant:

  • Conducted on

  • Prepared by

  • Personnel

  • Priority of Close Out/Risk Ratings
    High - Close out action within 7 days
    Medium - Rectify within 30 days
    Compliant - No Action Required

Fire Safety Observations

  • Appropriate signage in place above each extinguisher?

  • Fire action notices suitably displayed throughout premises and information correct?

  • Emergency exits routes and final exits appropriately marked with signage

Means of Escape

  • Emergency exits routes kept clear and free of hazard

  • Escape routes sufficiently lit

  • Fire doors kept locked where required

  • Fire doors in good condition and can freely open

  • Final exits- Emergency push bar hardware in good working condition

  • Is there adequate fire stopping on escape routes

  • Back of house areas outside tenants kept clear

General H & S Observations

  • Visual-Fire alarm system & PAVA

  • Visual- Sprinklers suppression system

  • Visual- Fire fighting equipment

  • Visual-Passive fire protection

  • Visual- Ansul Suppression system

  • Visual- Extraction and Ventilation

  • Visual- Filter Cleanliness

  • Visual- Emergency Lighting

  • Visual- Ad hoc PAT testing

  • Visual- General Housekeeping

  • Health and safety poster clearly displayed or staff given HSE leaflet

First Aid

  • Location and supplies of first aid kits adequate

  • Comments

  • Relevant images

Workplace Environment

  • Housekeeping standards good (sanitary conditions achieved)

  • Lighting adequate for work conducted

  • Pest control in place

  • Floor clean and trip/slip hazard free

  • Storage provided for clothing and PPE

  • Comments

  • Relevant images

Food hygiene

  • Good standards of cleanliness and hygiene maintained

  • Food appropriately stored (indoor and outdoor storage)

  • Fridge/ freezer temperature checks in place

  • Food in date and rotated

  • Food labelling in place

  • Colour coded boards used

  • Suitable provision of hand washing facilities

  • Insectocuters in place and working

  • Comments

  • Relevant images

Hazardous flammable substances

  • Suitable storage of flammable/hazardous substances

  • Comments

  • Relevant images

Accident Management

  • Accident book easily accessible to staff and staff aware of location

  • Comments

  • Relevant images

Fats Oils Grease FOG

  • Grease extractor installed and maintenance records available

  • Cooking oil waste removed and stored appropriately

  • Comments

  • Relevant images

Additional Observations

  • Observation 1 and Action Required

  • Observation Photo

  • Observation 2 and Action Required

  • Observation Photo

  • Observation 3 and Action Required

  • Observation Photo

  • Observation 4 and Action Required

  • Observation Photo

  • Observation 5 and Action Required

  • Observation Photo

Summary of report

  • Comments

Signature- AEG

  • Add signature

  • Select date

Signature- Tenant

  • Add signature

  • Select 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.