Title Page

  • Period of Inspection

  • Area of Inspection

  • Prepared by

  • Any Other Personnel Present

Fire Safety Systems

Fire Resisting Doors & Means Of Escape

  • Fire door vision panels are in good condition and clear of obstructions

  • Fire door has 3 or more Hinges which are secure with no screws missing

  • Fire doors have intumescent seals which are in good condition (not painted, missing or damaged)

  • Fire door handles are secure, functioning correctly and can be opened without the use of a key

  • No signs of wedging/chocking open doors

  • Self closing devices are fixed to door and frame securely

  • Fire doors close fully & shut tight by use of its own Self Closing (SC) Device

  • Fire exit signage in place

  • Fire alarm call points accessible and free from damage

  • Fire action notices in place and legible

  • Emergency arrangements in place for all persons with a disability

  • Name and Signature of Inspector

Fire Extinguisher

  • The operating instructions of each extinguisher are clean, legible and face outwards

  • The seals and tamper indicators of each extinguisher are not broken and missing

  • The reading of any pressure gauge or indicator fitted to an extinguisher is within operational and safety limits

  • Each extinguisher has not been operated and is not obviously damaged or has any missing parts

  • Each extinguisher is correctly located, suitably serviced and in the designated place

  • Each extinguisher is unobstructed, visible and has relevant ID signage above them

  • Name and Signature of Inspector

  • Date of Inspection

Emergency Lighting

  • Emergency Lighting Test

  • Date of Test

  • Name and Signature of Tester

Fire Prevention & Electrical Safety

Fire Prevention

  • Area clear of combustible materials

  • No smoking policy is being observed

  • Waste bins being emptied regularly

  • Ceiling tiles in place

Electrical Safety

  • Wall socket outlets undamaged

  • Portable electrical equipment in use with current PAT

  • Multi socket extension leads are being used correctly (e.g. no multi sockets plugged into other multi sockets/adaptors and not exceeding permitted amps)

  • Power cables safely routed and in good repair (No fraying, damage or exposed wires)

  • Name and Signature of Inspector


  • Are all known locations of Asbestos in good state of repair?

  • Name of inspector

  • Date of Inspection

Ladders, Pallet Trucks and Trolleys

  • Ladder ID number & Location

  • Plant / ID Number clearly legible and marking intact

  • No loose, cracked or broken rungs, rails, braces or ropes

  • No loose nails, screw bolts or other parts

  • No splintered or sharp edges

  • No damaged or worn non-slip steps or base

  • No foreign matter on the ladder such as grease, oil, paints

  • No loose, defective, broken or missing extension locks

  • Hinge spreaders not loose or bent (stepladders / trestles)

  • Stop guard on hinge spreaders not broken or damaged (stepladders / trestles)

  • Retaining cords are of equal length and in good condition

  • No damage or worn stiles (warping, sagging or distortion)

  • Stable when open and standing on a level base (Stepladders)

  • Name/Signature of inspector

  • Date of Inspection

  • Trolley
  • Trolley ID number & Location

  • Wheels are in good repair

  • Handle

  • Bolts and fasteners

  • Any other signs of defects or damage

  • Name/Signature of inspector

  • Date of Inspection

Outdoor Play Equipment

    Play Equipment
  • Take photo of structure or identify equipment

  • Structure is free of bending, warping, cracking, loosening and breaking

  • Surface finish adequate (protective coating missing, rust or other corrosion, cracks, splinters, broken or open joints.)

  • All items such as nuts, bolts washers, shackles etc are adequate (not missing, bent, broken, loosened, worn, open hooks, etc.)

  • Edges are free of protrusions, sharp points or sharp edges

  • No pinch or crush points present(Exposed mechanisms, junctures or moving components, etc.)

  • Guard or hand rails/swing barriers aren't missing, bent, broken, loosened.

  • Mechanical devices and moving parts checked for worn bearings, lack of lubrication, seizure or excessive motion, missing covers.

  • Review swing and other seats (missing, damaged, loosened, sharp corners, insecure fittings, etc.)

  • Look for missing or broken rungs, steps or treads loosening, etc.

  • Foundations aren't cracked, loose in ground or exposed.

  • Impact absorbing surfaces aren't compacted, displaced or not extensive enough to cover possible impact area

  • Drain holes are clear

  • Signature person carrying out inspection(s) of outdoor equipment

  • Date/time of Inspection

Any Other Issues

  • Defects Log

  • Issue
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