University Care Quarterly Inspection

• Document No.

• Audit Title University Care Quarterly Inspection

• Client / Site: UMMS University Care

• Conducted on

  Date

• Prepared by Ted Saunders, CFPS

• Location 4835 Edmondson AV.
  Address

• Personnel

Building Information

• Number of floors: 1

• Occupancy type: Medical Offices

• Number of exits at level of exit discharge: 3

Emergency Procedures

• Emergency plan is up to date and on file.

  Yes

  No

  N/A

• Evacuation drill conducted within the past 12 months.

  Yes

  No

  N/A

• Evacuation floor plans posted.

  Yes

  No

  N/A

Exit Components

• Number of exits: 3

• Means of egress is clear, unobstructed, and unlocked.

  Yes

  No

  N/A

• Fire doors and exit doors are in good condition and functioning properly.

  Yes

  No

  N/A

• Exit signs are functional and placement is adequate.

  Yes

  No

  N/A

• Emergency lights are working properly, placement is adequate, and monthly testing is conducted.

  Yes

  No

  N/A

Fire Alarm

• Fire alarm is powered and free of trouble or supervisory signals

  Yes

  No

  N/A

• Alarm pull stations, detection and audio/visual devices appear functional and unobstructed.

  Yes

  No

  N/A

• Batteries are in good condition and up to date.

  Yes

  No

  N/A

• Date of last test/maintenance

  Date

• Vendor report available for review.

  Yes

  No

  N/A

Automatic Sprinkler System

• Gauges are functional, in good condition, with adequate system pressures.

  Yes

  No

  N/A

• Valves are are accessible, in good condition and in proper open or closed position.

  Yes

  No

  N/A

• Sprinkler heads and other components are in good condition and properly placed.

  Yes

  No

  N/A

• Minimum 18" clearance provided below sprinkler deflector.

  Yes

  No

  N/A

• Spare sprinkler heads and wrench provided.

  Yes

  No

  N/A

• Fire department connection is accessible, properly marked, and in good condition with protective caps in place.

  Yes

  No

  N/A

• Date of last sprinkler system test/maintenance.

  Date

• Vendor report available for review.

  Yes

  No

  N/A

• Date of last 5-year interior check valve inspection.

  Date

• Date of last back-flow prevention test.

  Date

• Date of last 5-year internal inspection by flushing.

  Date

Portable Fire Extinguishers

• Extinguishers are properly mounted, fully charged, undamaged, visible, and accessible.

  Yes

  No

  N/A

• Distribution is adequate with placement within travel distance requirements.

  Yes

  No

  N/A

• Monthly inspections are conducted and documented on extinguisher tag.

  Yes

  No

  N/A

• Date of last annual service.

  Date

General Fire Safety

• All areas are clear of excessive combustible storage.

  Yes

  No

  N/A

• Flammable/combustible liquids are properly stored.

  Yes

  No

  N/A

• Minimum 36" clearance provided around heat-producing appliances.

  Yes

  No

  N/A

• Electrical equipment and devices are properly used and maintained.

  Yes

  No

  N/A

• "No Smoking" regulations are enforced.

  Yes

  No

  N/A

• Mechanical, electrical rooms, and other areas are code compliant.

  Yes

  No

  N/A

• Additional notes

• Add signature

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