Employer / Responsible Person
Address of Property
Person(s) Consulted
Assessor
Date of Fire Risk Assessment
Date of Previous Fire Risk Assessment
Suggested Date for Review
1. THE BUILDING
1.1 Number of floors
1.2 Approximate floor area
1.3 Brief details of construction
1.4 Occupancy
Any other comments (The Building)
2. THE OCCUPANTS
2.1 Approximate maximum number
2.2 Approx. maximum number of employees at any one time
2.3 Maximum number of members of public
Any other comments (The Occupants)
3. OCCUPANTS AT SPECIAL RISK
3.1 Sleeping occupants
3.2 Disabled occupants
3.3 Occupants in remote areas
3.4 Others
Any other comments (Occupants at Special Risk)
4. FIRE LOSS EXPERIENCE
Any other comments (Fire Loss Experience)
5. OTHER RELEVANT INFORMATION
Any other comments (Other Relevant Information)
6. RELEVANT FIRE SAFETY LEGISLATION
Any other comments (Fire Safety Legislation)
7. ELECTRICAL SOURCES OF IGNITION
8. SMOKING
9. ARSON
10. PORTABLE HEATERS AND HEATING INSTALLATIONS
11. COOKING
12. LIGHTNING
13. OTHER SIGNIFICANT IGNITION SOURCES THAT WARRANT CONSIDERATION
14. HOUSEKEEPING
15. HAZARDS INTRODUCED BY OUTSIDE CONTRACTORS AND BUILDING WORKS
Any other comments (Fire Hazards)
16. MEANS OF ESCAPE FROM FIRE
17. MEASURES TO LIMIT FIRE SPREAD AND DEVELOPMENT
18. ESCAPE LIGHTING
19. FIRE SAFETY SIGNS AND NOTICES
20. MEANS OF GIVING WARNING IN CASE OF FIRE
21. MANUAL FIRE EXTINGUISHING APPLIANCES
22. RELEVANT AUTOMATIC FIRE EXTINGUISHING SYSTEMS
23. OTHER RELEVANT FIXED SYSTEMS
Any other comments (Fire Protection Measures)
24. PROCEDURES AND ARRANGEMENTS
Any other comments (Management of Fire Safety)
List the actions required, who is responsible, and the target completion date.
Any other comments (Fire Action Plan)
Overall Comments / Summary
Front of Property Photo
Notes for the assessor: 1. You still need to take photos and upload them to Dropbox. 2. You still need to create a comprehensive action plan to accompany this report.