Information
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Vinci Response Services Ref.
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Customer name
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Location
undefined
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Report completed by
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Mobile no of technician
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Date of visit
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Document No.
Job specifics
You must insert a photograph of the property
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Please insert photo of the property
Building fabric information
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Approximate date of construction of the property
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Type of property
- Detached
- Semi-detached
- End-terraced
- Mid-terraced
- Bungalow
- Dormer bugalow
- Cottage
- Flat / apartment / tenement
- Listed property
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Provide details of the main construction of the external walls
- Solid - brick
- Solid - stone
- Solid - cob
- Cavity: brick - brick
- Cavity: brick - block
- Cavity: block - block
- Other
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Please confirm details for "other" item(s)
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Provide details of the main construction of internal walls
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Please confirm details for "other" item(s)
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Confirm details of the floor construction (ground)
- Suspended with timber floorboards
- Suspended with chipboard floor
- Solid concrete
- Solid concrete with floating floor
- Other
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Please confirm details for "other" item(s)
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Details of internal woodwork
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Please confirm details for "other" item(s)
Peril information
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Damage caused by:
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Source of the water
- External water main
- Internal cold water feed pipe
- Internal hot water feed pipe
- Internal waste pipe
- Ingress due to roof failure
- Drainage failure
- Flood of river / sea water
- Other
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Provide detail of water source
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Depth of water
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Type of water
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Category of fire
- Fast burning
- Slow burning
- Protein
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Types of soot residues identified/ possible
- Corrosive
- Dry
- Odorous
- Plastic
- Protein
- Wet
- Not known
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Provide a brief description of what has caused the damage (if the damage was caused by fire then please confirm the seat of the fire)
Risk Assessment
Site specific risk assessment.
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You must provide confirmation of site specific issues noted during the visit.
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Are there any disabled persons living at the property?
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Provide further information
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Are the works likely to affect access to/from the property?
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Provide further information
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Are there any elderly / infirm persons living at the property?
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Provide further information
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Are there any young children living at the property?
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Provide further information
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Are there any pets, particularly dogs?
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You need to confirm that the customer is able to keep the pets in a secure location away from the work area.
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Provide further information
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Are there any other personal considerations to be taken into account?
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Provide further information
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Please enter any additional comments here
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Make an assessment of all hazards that could impact on operatives, the customer and the general public at this site. List them all here.
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Select all relevant hazards identified during your visit
- Slips / trips / falls
- Electric shock
- Chemical handling
- Manual handling
- Falling debris
- Sharps / knives / needles
- Bio / toxic hazard
- Working at heights
- Lone working
- Confined spaces
- Deep water & concealed sumps, etc
- Transport of plant / goods
- Provision & Use of Work Equipment
- Poor lighting
- Potential asbestos containing materials
- Other
- None identified
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You have identified the possibility of ACMs in the property. Have you either taken a sample (by reference to the correct sampling methodology) or arranged for a sample to be taken for testing?
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Provide details of any asbestos testing requirements so that this can be arranged
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Are the electrics suitable for use?
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Provide details of any electrical works required
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Please confirm details of other hazards identified:
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Are any emergency works required?
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Provide details of any emergency works required
Site inspection report
Confirmation of stabilisation work undertaken in each area.
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Remember that the stabilisation phase is about getting rid of any standing water, removing any wet /potentially contaminating items, quickly assessing items that could potentially be restored, controlling the environment of the property and producing a plan of action in order to minimise any subsequent secondary damage.
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Tap on "Add Area no." to create the 1st area. This will open up Work Area 1 and allow you to start creating the details of that work area. This will allow you to confirm details of each area and detail what stabilisation work you have undertaken. It will also allow you to complete a moisture measurement plan and add in a number of readings for that area (though this may be required at the final stabilisation visit).
You can add in new areas by either tapping "Add Area no." again or by tapping the "+ Add" button that is on the 1st area. -
Add in a new area for each room
Area no.
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Room / area
- Porch
- Hall
- Lounge
- Dining room
- Kitchen
- Conservatory
- Utility room
- Larder
- WC
- Under stairs cupboard
- Study
- Other reception room
- Stairwell
- Garage
- Cellar
- Landing
- Bedroom 1
- Bedroom 2
- Bedroom 3
- Bedroom 4
- Bedroom 5
- Bathroom
- En suite
- Loft
- Other room(s)
- N/A
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Enter the names of the "other" rooms
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Is the room box or L-shaped?
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Room length (metres)
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Room width (metres)
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Room height (metres)
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Length of inset (metres)
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Width of inset (metres)
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Have kitchen units been damaged by the peril?
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Approximate quality specification of kitchen
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Confirm details of the damaged items
- Base units - carcass only
- Base units - including fronts
- Wall units - carcass only
- Wall units - including fronts
- White good housing units - carcass only
- White good housing units - including fronts
- Worktops
- Plinths
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Please remember that you need to actually use the slider to select the quantity (so if your answer is "0" you need to move the slider along and then back to "0"). If you don't do so the form will think you have not provided an answer.
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No of damaged base units
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No of damaged wall units
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No of undamaged base units
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No of undamaged wall units
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Please add at least 2 general shots of the room and views of the affected area so that subsequent visitors could recognise the room.
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Remember that this report is being sent to people that have/may not visited the property. Your photographs need to help show what has happened. Do not add blurred or dark images.
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Have any contents been affected as a result of the incident?
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This section requires completion to list all contents that you need to work on in order to stabilise the property and reduce further damage. For example if you need to move the item to an unaffected area to prevent secondary damage then list it here.
There is no need to use this section to list BER items. This is about listing items where your restoration skills help to save items that can be saved. -
You now need to click "+ Add Item No." to begin listing details of each item that you are dealing with as part of the stabilisation of the property. Further items can be added by also selecting "+ Add".
Item No.
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You will need to complete a description, assessment of the age, pre-incident condition, approximate value to replace, your triage assessment of condition and confirm what action you have completed on each item.
If the item is electrical then please try to record the make, model and serial numbers of the item.
If there are a number of similar items then there is no need to list them individually at this stage, though you should try to group them together depending on your triage assessment of their condition. -
Description of the item
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Please add useful photos of the item(s)
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Age of the item
- <1 year
- 1-2 years
- 2-3 years
- 3-4 years
- 4-5 years
- 5-10 years
- >10 years
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Approximate cost of the item
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Assessment / view of the pre-incident condition of the item(s)
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Triage assessment of the item<br>R = restorable, A = attempt restoration
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Action taken with the item
- Inspected only
- Removed to another room
- Removed outside or to an outbuilding
- Removed & disposed
- Packaged & boxed for storage off site
- Removed to off-site storage
- Restore on site
- Appointed specialist restorer
- Further action required
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Provide details of the further action required
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To add additional items go back up the form and select the "+ Add Item No." or "+ Add" buttons
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Detail all of the actions that you have undertaken to stabilise this work area.
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Confirm what equipment has been left in this area and advise the expected duration on site (for authorised drying cases)
- Dessicant dehumidifiers
- Refrigerant dehumidifiers
- Air movers / paddle fans
- Air scrubbers / managers
- Other equipment
- None
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How many Dessicant dehumidifiers?
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How many days do you expect them to be on site (if working on an authorised drying case)?
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How many refrigerant dehumidifiers?
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How many days do you expect them to be on site (if working on an authorised drying case)?
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How many air movers / paddle fans?
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How many days do you expect them to be on site (if working on an authorised drying case)?
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How many air scrubbers / managers?
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How many days do you expect them to be on site (if working on an authorised drying case)?
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Confirm type of equipment
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How many other items?
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How many days do you expect them to be on site (if working on an authorised drying case)?
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Do you need to include details of moisture measurement readings in this report?
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Provide a sketch plan locating the "moisture reading locations" and the "datum moisture reading locations" as per the standard measures. You need to show where each of your readings has been taken rom (including your equilibrium target measure) by drawing a number that corresponds with the readings that you take.
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Provide details of moisture readings taken in this area
Moisture reading at location
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Add readings taken at this location
Reading no.
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Type of reading
- Concrete Moisture Content
- Equilibrium Relative Humidity
- In Depth Probes
- Moisture Content in Wood
- Datum CMC
- Datum ERH
- Datum IDP
- Datum MCiW
- Other
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Reading obtained
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Temperature at time of reading (in degrees C)
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Select date
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It may be that you wait until all necessary stabilisation has been completed before taking these readings as this could make a difference.
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Remember, you can add in new areas by either tapping "Add Area no." again or by tapping the "+ Add" button that is on the 1st area.
Summary
Summary
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Provide confirmation of what actions you have taken during the visit and a summary of how you have left things. If you have stripped items out then confirm exactly what you have done and why. If you have left equipment on site then list what you have left, where it is and why you think it was of benefit to do so.
You will also need to advise if there are any issues that could affect the drying / restoration of the property. -
Provide a summary of your inspection findings and justification for the work completed:
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Are there any pre-existing problems / issues that could affect the drying / restoration of the property?
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Provide full details of any issues
Classification of damage
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You need to provide details regarding the severity of the damage at the property.
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Is the property habitable?
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Is the condition of the property minor enough to allow the customer to still live at the property? Do they still have use of cooking, washing and toilet facilities? If not at present could your prompt actions affect this?
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Consider how bad the damage is and whether immediate or prompt action could reduce the impact of the damage and make the property habitable sooner rather than later. Consider this when putting your action plan together.
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What category does the damage fall into?
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Cosmetic: classed as damage to the finishes of the property, eg smoke / soot / water damage to wallpaper, laminate floors, etc.
Minor structural: classed as damage to plaster, flooring materials, etc.
Major structural: As minor but with damage to structural timbers, major roof damages, etc. -
Ensure that you consider the severity of the damage and highlight what would be required to minimise the potential for secondary damage.
Action plan for Buildings element following this visit:
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You need to provide details of all steps necessary to progress the Building element of this claim. Think about what the barriers to movement are and what needs to be done to remove them. If you need asbestos test results, electricians, etc then provide detail.
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Action plan details
Action no.
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What needs to be done next in order to move this claim forward?
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Action due by:
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Specify person responsible for action
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Based on the Action Plan produced confirm the anticipated next inspection date
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For stabilisation we do not expect that the "anticipated next inspection date" will be more than 5 days from the date of the 1st visit.
If authority has been given to move to a standard drying phase then provide details of the next review date. -
Have you kept the customer fully informed of your proposed actions?
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Please explain why the action plan has not been discussed with the customer
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Sign confirming Buildings action plan
Action plan for Contents element following this visit:
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You need to provide details of all steps necessary to progress the Contents element of this claim. Think about what the barriers to movement are and what needs to be done to remove them. If you need asbestos test results, electricians, a clean room for storage of contents, etc then provide detail.
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Action plan details
Action no.
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What needs to be done next in order to move this claim forward?
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Action due by:
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Specify person responsible for action
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Based on the Action Plan produced confirm the anticipated next inspection date
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For stabilisation we do not expect that the "anticipated next inspection date" will be more than 5 days from the date of the 1st visit.
If authority has been given to move to a standard drying phase then provide details of the next review date. -
Have you kept the customer fully informed of your proposed actions?
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Please explain why the action plan has not been discussed with the customer
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Sign confirming Contents action plan