Fire Risk Assessment Form

Name of person consulted:

Email:

Name of responsible person for fire safety in the building:

Address of premises:

Date of previous risk assessment:

If available, attach previous risk assessment:

Number of floors at ground level and above:

Number of floors entirely below ground level:

Floors on which car parking is provided:

Number of flats:

Approximate gross floor area:
m²

Brief details of construction and approximate age of building:

Attach picture of front of building:

Occupancy & intended use of property:

Reason for requesting fire assessment:

The occupants

Approximate maximum number of employees at any one time:

Approximate maximum number of residents and visitors at any one time:

Occupants especially at risk from fire

Sleeping occupants:
YesNo

If yes, how many sleeping occupants?:

Occupants in remote areas and lone workers:

Others?

Disabled occupants (if known):

Fire loss experience

Has there been any fires in the past?:

Cost of the past fire losses in £:

Is there any alteration notice in force?:

General risk assessment questions

Who is responsible for the overall fire safety at the premises and managed by whom?:

Please attach fire strategy, if there are suitable records of fire safety arrangements:

Is there an evacuation strategy in place?:
YesNo

If yes, attach evacuation strategy document:

Is there an emergency lighting in the property & when was it last tested by a competent contractor?:

If yes, please attach the most up-to-date service certificate/ report:

Is a fire system in the property conforming to BS5839 & when was it last tested by a competent contractor?:

If yes, please attach the most up-to-date service certificate/ report:

Is monthly and annual testing carried out on the emergency light (3hr run down test)?:
YesNo

If so, please upload evidence (e.g., log book):

Do you have extinguishing media in place (e.g., fire extinguishing media)? If so, please identify what extinguishing:

What date was the last EICR carried out on the internal property's electrical distribution board?

Please upload last completed EICR:

Are there appropriate records available of fire alarm and emergency lighting tests?:
YesNo

If able to do so, then please upload here:

Is there a suitably located premises information box for the fire and rescue services on site?:
YesNo

If so, please upload a picture of this:

Are there arrangements in place to keep the premises information box up to date?:

Is the emergency lighting and fire alarm under contract? If so, when was the last service performed and when is the next service due?:

Is fire information disseminated to staff/residents?:
YesNo

Please upload any documents given out to staff/residents:

Are fire drills carried out regularly? If so, when was the previous one carried out?:

Please upload evidence of previous fire drill (e.g., log book entry):

What training has staff carried out in relation to fire safety training, if applicable (e.g., fire marshal, fire extinguisher training)?:

Please upload copies of these:

Does anyone have a specific role in fire safety within the building? If so, please state names and roles:

Additional information

Additional information