Assessment Details

Company Name:

Site Address:

Assessment Date:

Assessor Name:

Assessor Position:

Review Date:

Building Information

Building Use:

Number of Floors:

Approximate Floor Area (m²):

Building Construction Type:

Maximum Occupancy:

Normal Hours of Occupancy:

Fire Hazards Identification

Sources of Ignition

Potential Ignition Source	Present? (Y/N)	Control Measures in Place	Additional Actions Required
Electrical equipment
Portable heaters
Cooking equipment
Smoking
Naked flames/candles
Hot work processes
Arson
Other (specify)

Sources of Fuel

Potential Fuel Source	Present? (Y/N)	Control Measures in Place	Additional Actions Required
Paper/cardboard
Furniture
Wood
Flammable liquids
Flammable gases
Plastics/rubber
Textiles
Waste materials
Other (specify)

Sources of Oxygen

Potential Oxygen Source	Present? (Y/N)	Control Measures in Place	Additional Actions Required
Natural ventilation
Mechanical ventilation
Oxygen cylinders
Oxidizing chemicals
Other (specify)

Fire Detection and Warning Systems

Type of Detection System:

Coverage:

Warning System Type:

Audibility:

Testing Frequency:

Last Test Date:

Maintenance Contractor:

Last Service Date:

Fire Fighting Equipment

Type	Location	Last Inspection Date	Suitable? (Y/N)	Comments

Emergency Escape Routes and Exits

Escape Route	Adequate? (Y/N)	Clear of Obstructions? (Y/N)	Properly Signed? (Y/N)	Emergency Lighting? (Y/N)	Comments

Emergency Evacuation Procedures

Assembly Point Location:

Evacuation Procedure Document Location:

Personal Emergency Evacuation Plans Required:

Fire Drills Frequency:

Last Fire Drill Date:

Fire Drill Comments:

Staff Training

Fire Safety Training Provided to Staff:

Training Frequency:

Training Records Location:

Last Training Date:

Fire Wardens/Marshals Appointed:

Fire Warden Training Date:

Risk Assessment

Risk to Persons

Group	Risk Level (Low/Medium/High)	Control Measures	Additional Actions
Staff
Visitors
Contractors
People with disabilities
Others

Overall Fire Risk Assessment

Risk Level:

Priority Actions Required:

Additional Comments

Action Plan

Action Required	Priority (High/Medium/Low)	Person Responsible	Target Date	Completion Date

Assessment Sign-Off

Assessor Signature:

Date:

Responsible Person Signature:

Position: