FIRE RISK ASSESSMENT FORM

ASSESSMENT CONDUCTED BY	ASSESSMENT DATE	NEXT ASSESSMENT DUE

LOCATION INFORMATION

NAME
ADDRESS
PURPOSE
OWNER NAME
OWNER CONTACT INFORMATION
MAXIMUM OCCUPANCY
BUSINESS HOURS if applicable
RESPONSIBLE PARTY NAME AND POSITION
RESPONSIBLE PARTY CONTACT INFORMATION

HAZARD ASSESSMENT CHECKLIST

Yes	No	N/A	HAZARD ASSESSMENT ITEM	NOTES
Are heating sources (fixed or portal) kept clear of combustible materials?
Are multipoint adaptors and electrical extension leads kept to a minimum?
Is electrical equipment regularly inspected for faulty or damaged wire?
Is smoking permitted on the premises?
Are combustible materials safely stored away from sources of ignition?
Are flammable liquids safely stored away from sources of ignition?
Are procedures in place to minimize the risk of and protect from arson?
Other
Other
Other

HAZARD ASSESSMENT ACTION PLAN

HAZARD	LOCATION	PARTIES AT RISK	RISK PROBABILITY H, M, L	CONTROL MEASURES	OWNER

ADDITIONAL INFORMATION REGARDING HAZARD ASSESSMENT

FIRE ALARM AND DETECTION CHECKLIST

Yes	No	N/A	FIRE ALARM AND DETECTION ITEM	NOTES
Are smoke detectors tested monthly?
Are smoke detector batteries replaced at least once or twice a year?
Is the fire alarm audible from all spaces in the building?
Are the number and locations of fire call points throughout the building satisfactory?
Are any fire alarms or call points obstructed from view or access?
Are all personnel in the building aware of how to raise an alarm?
Are fire alarms tested and serviced in accordance with BS 5839 standards?
Does the alarm system have a backup battery in place?
Other
Other

FIRE ALARM AND DETECTION ACTION PLAN

HAZARD	LOCATION	PARTIES AT RISK	RISK PROBABILITY H, M, L	CONTROL MEASURES	OWNER

ADDITIONAL INFORMATION REGARDING FIRE ALARM AND DETECTION

SAFE ESCAPE FROM FIRE HAZARDS CHECKLIST

Yes	No	N/A	SAFE ESCAPE FROM FIRE HAZARDS ITEM	NOTES
Are there at least two escape routes located in each space?
Are all escape routes unobstructed and easily accessible?
Can all escape points be exited quickly without the use of a key?
Is there sufficient exit signage located in each space, and does it comply with BS 5499?
Are illuminated exit signs required?
Is emergency lighting in place and properly functioning?
Are all exit routes sufficiently illuminated?
Is emergency lighting tested and maintained according to BS 5266?
Other
Other

SAFE ESCAPE FROM FIRE HAZARDS ACTION PLAN

HAZARD	LOCATION	PARTIES AT RISK	RISK PROBABILITY H, M, L	CONTROL MEASURES	OWNER

ADDITIONAL INFORMATION REGARDING SAFE ESCAPE FROM FIRE HAZARDS

FIRE FIGHTING EQUIPMENT CHECKLIST

Yes	No	N/A	FIRE FIGHTING EQUIPMENT ITEM	NOTES
Is there an adequate number of fire extinguishers available?
Are fire extinguishers located in higher fire hazard areas?
Have fire extinguishers been properly serviced and tested?
Are fire blankets available?
Is a working sprinkler system installed in the building?
Is there a working gas flooding system in the building?
Are fixed installations tested according to BS standards?
Do all protection systems include working alarms?
Other
Other

FIRE FIGHTING EQUIPMENT ACTION PLAN

HAZARD	LOCATION	PARTIES AT RISK	RISK PROBABILITY H, M, L	CONTROL MEASURES	OWNER

ADDITIONAL INFORMATION REGARDING FIRE FIGHTING EQUIPMENT

STAFF TRAINING CHECKLIST

Yes	No	N/A	STAFF TRAINING ITEM	NOTES
Are staff members trained on how to report a discovered fire?
Are staff members trained on how to raise the fire alarm?
Are staff members trained on how to use a fire extinguisher?
Are staff members trained on evacuation procedures?
Are staff members trained on alerting other staff and personnel about a fire?
Are team leaders or roles assigned to help facilitate safe escape?
Are staff members trained on where to go for a safe assembly point?
Are staff members trained regarding specific hazards on the premises?
Other
Other

STAFF TRAINING ACTION PLAN

HAZARD	TRAINING	POINT OF CONTACT	DATE OF LAST TRAINING	DATE OF NEXT TRAINING	LOCATION OF DOCUMENTS

ADDITIONAL INFORMATION REGARDING STAFF TRAINING

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