Professional Documents
Culture Documents
SITE/ADDRESS:
DATE/S OF ASSESSMENT: ..
Name of Responsible person on site: .
Tick appropriate boxes. Not all items are applicable to all sites tick N/A if not applicable to the site being
assessed.
1.0 RISK ASSESSMENTS GENERAL
Have risk assessments been carried out in accordance with the
requirements of the legislation listed below?
1.1
YES
NO
N/A
Date of Issue:
Note: A Fire Clearance certificate is required for premises used as offices or shops where:
2.2
2.3
Staff Training
a. Are staff trained every 6 months? (3 months for night shift?)
b.
Have names of all staff trained, full & part time, been entered
the Fire Log Book relevant section?
YES
NO
N/A
3.0 LIAISON
a. Is good liaison maintained with the Fire Authority?
b.
c.
Are the fire evacuation assembly areas in safe areas, clear of the
building & away from the fire brigade vehicle access & parking?
d.
e.
YES
NO
N/A
e.
f.
g.
h. Have Fire Marshalls been appointed & trained for each floor/
area? Attach a list of Fire Marshalls & areas of responsibility
i. Do all staff know who their Fire Marshalls are & how to
contact them?
j.
Are staff trained to operate the fire alarm call points, & to use hose
reels/extinguishers to put out small fires?
NO
N/A
g.
Are all fire exit doors easily opened from inside without the use
of a key?
(ii)
(iii)
c.
d.
(ii)
b.
c.
Water
CO2
Dry Powder
Fire Blankets
d.
e.
c.
(i)
(ii)
b.
c.
d.
Is the fire alarm monitored 24 hours a day & can the exact
location where the alarm was activated be identified?
e.
f.
NO
N/A
b.
Note: Portable coal, paraffin or gas heaters are not allowed on the
premises
15.0 HYDRANT SYSTEMS
a.
b.
Are the stand pipes protected from damage & identified with
sign For fire use only *
* Signs must comply with SABS specifications
c.
Are the large bore hoses & nozzles secured in a red lockable
box next to the stand pipe?
d.
Are staff prevented from using the stand pipes for drawing
water/washing/watering gardens, etc?
e.
Are the stand pipes serviced annually with other fire fighting
equipment & form part of the Service log book/Register?
f.
NO
N/A
g.
Name of Assessor/s:
....
Signature:
Position:....
Date:.
Name of Responsible Person: ...
Signature:..
Position:....
Date:..