Fillable Printable Fire Safety Risk Assessment Form
Fillable Printable Fire Safety Risk Assessment Form
Fire Safety Risk Assessment Form
The Regulatory Reform (Fire Safety) Order 2005
FIRE RISK ASSESSMENT
Employer or other
responsible person
Name of Premises
Address
Post Code Telephone N
o
Name of Assessor(s)
Date of Assessment Date of Review
Building GENERAL INFORMATION
Property Use
N
o
of floors
N
o
of floors below
ground
Approx area in m
2
of footprint
of building
Age of building
Brief details of construction
GENERAL INFORMATION
Building Occupants
Enter range A= <20, B= 20 – 49, C=50-99, D=100-1000, E= >1000
Occupancy Profile:
Maximum Number of persons, in the
most highly occupied compartment
to be effected by an uncontrolled fire
within 30 minutes, assuming no
evacuation.
WEEKDAYS WEEKENDS
0000 to 0400 0000 to 0400
0400 to 0800 0400 to 0800
0800 to 1200 0800 to 1200
1200 to 1600 1200 to 1600
1600 to 2000 1600 to 2000
2000 to 2400 2000 to 2400
Description of Occupants:
Predominant Type
Atypically mobile for this type of occupancy
Average mobility for this type of occupancy
Untypically vulnerable for this type of occupancy
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Potential Loss/Risk
Sole Supplier in UK:
If yes give brief details:
Yes No
Providing high value
or unique service or
products:
Exceptional Value:
Value of rebuild and
restock:
If yes give brief details:
Yes No
Heritage Risk:
Building of National
Importance or
international
significance.
If yes give brief details:
Yes No
Community Loss:
Exceptional value or
impact to the
community.
If yes give brief details:
Yes No
Property Loss:
Estimate the extent of
Tick one
box
below
Estimate damage
within 50m
2
fire and smoke
damage arising from
an uncontrolled fire
and whether it is likely
to be:
Note: Tick only one box
in this section
Damage beyond building
of origin:
Confined to room or
compartment of origin:
Confined to the floor of origin:
Confined to the building of
origin:
Tick one box below
Less than 500m
2
500m
2
to 999m
2
1000m
2
to 9999m
2
100000m
2
to 100000m
2
Over 100000m
2
Other Relevant Information:
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Building Plan
Insert plan of your building here or if you do not posses one, use this sp ace to draw your building floor plan (this
does not have to be to s cale). Further guidance can be found i n Part 1 S ection 4.1 of the appropriate guide.
Mark on all fire precautions equipment e.g. Fire doors, Extinguishers, Emergency lighting, Fire alarm and any fire
detection.
Does the premises appear to meet the necessary requirements that are defined in Part 2 of the
appropriate guide?
If the answer is NO, then as a s ignificant finding, document the deficiency and any remedial actions necessary in
order to comply with the requirements.
KEY
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FIRE HAZARDS AND THEIR ELIMINATION OR CONTROL
1. SOURCES OF FUEL
1.1 Are there any highly flammable substances in the premises. E.g.
Paints, thinners, flammable gases etc, flammable chemicals,
plastics, rubber, foams – polystyrene / polyethylene?
Yes
Go to 1.2
No
Go to 1.3
1.2 Control Measures
Replace them with safer alternatives
Remove or significantly reduce any highly flammable substances
Keep them in fire resisting stores
Separate them from heat sources by use of fire resisting construction
Keep minimum quantity in workroom
Ensure all containers are kept closed when not in use
Other (state here)
Yes No
1.3 Are flammable liquids or gases used or stored in areas without
adequate Ventilation?
Go to 1.4 Go to 1.5
1.4 Control Measures
Improve ventilation
Other (state here)
1.5 Are there quantities of combustible material stored, on display, or in
use in the premises. E.g. Paper, cardboard, packaging, fabrics,
wood?
Yes
Go to 1.6
No
Go to 1.7
1.6 Control Measures
Replace stocks of combustible materials with non combustibles
Reduce stocks of readily combustible materials to a minimum
Separate such materials from heat sources or by fire resisting construction
Other (state here)
1.7 Are quantities of combustible waste allowed to accumulate in the
premises such as Paper, cardboard, wood shavings, dust?
Yes
Go to 1.8
No
Go to 1.9
1.8 Control Measures
Improve the arrangements for the disposal of waste and rubbish
Improve the general housekeeping
Ensure staff are aware of the standard of housekeeping required
Give specific additional training to the staff responsible
Other (state here)
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1.9 Does the premises contain foam filled furniture which is not
Yes No
combustion modified (see label) or is worn to the point that it exposes the
foam interior?
Go to 1.10 Go to 1.11
1.10 Control Measures
Replace or repair
Other (state here)
1.11 Are areas of walls or ceilings covered with combustible linings?
such as walls covered with carpet tiles, ceilings covered
with polystyrene tiles.
Do notice boards have large amounts of loose paper on them?
Yes
Go to 1.12
No
Go to 1.13
1.12 Control Measures
Remove
Reduce
Treat with fire resisting solution
Cover
Replace large notice boards with small
Other (state here)
1.13 Are combustible seasonal or promotional decorations, artificial foliage or
plants used to decorate the premises?
Yes
Go to 1.14
No
Go to 1.15
1.14 Control Measures
Remove
Treat with fire resisting solution
Introduce real plants
Replace with non combustible plants
Other (state here)
1.15 Are there additional sources of oxygen stored or used, such as
oxidising chemicals, oxygen cylinders or piped systems?
Yes
Go to 1.16
No
Go to 2.1
1.16 Control Measures
Move oxidising material away from any heat or flammable materials
Control use and storage of oxygen and chemicals
Remove sources of ignition
Other (state here)
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Note any significant findings from section 1:
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2. SOURCES OF IGNITION
2.1 Does the work activity involve hot work processes such as welding or flame
cutting, hot surfaces, sparks?
Are hazards introduced by outside contractors and building works?
Yes
Go to 2.2
No
Go to 2.3
2.2 Control Measures
Replace with a cold system
Implement a hot work permit system
Minimise the amount of combustible materials on the work area
Arrange so that hot metal and sparks are safely contained
Eliminate hot surfaces/sparks
Ensure satisfactory control over works carried out by outside contractors
Impose fire safety conditions on outside contractors
Other (state here)
2.3 Does the work activity involve processes such as incinerating or
Cooking?
Yes
Go to 2.4
No
Go to 2.5
2.4 Control Measures
Ensure that cookers, incinerators, etc. are used in accordance with manufacturer
instructions.
Ensure they are cleaned regularly including surfaces, ducts or flues
Ensure food cooking is not left unattended
Give additional specific training to staff responsible
Other (state here)
2.5 Are heating appliances portable or of a radiant or open flame type?
Yes
Go to 2.6
No
Go to 2.7
2.6 Control Measures
Replace equipment with fixed convector heaters
Ensure that gas or oil burning equipment is used in accordance with manufacturers
instructions
Ensure that all heaters are adequately guarded
Ensure all portable heaters are stable and void of flammable materials
Other (state here)
Yes No
2.7 Is smoking permitted?
Go to 2.8 Go to 2.9
2.8 Control Measures
Implement a smoking policy which provides for a safe smoking area and prohibition
elsewhere
Ensure suitable arrangement for informing visitors
Enforce the prohibition of matches and lighters in high-risk
Other (state here)
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Yes No
2.9 Are there light fittings near combustible materials?
2.10 Control Measures
Go to
2.10
Go to
2.11
Remove combustible materials
Replace tungsten/halogen bulbs with fluorescent tubes in areas where there is a
possibility that combustible materials may be ignited
Other (state here)
2.11 Is electrical equipment and wiring: Faulty, damaged or not used in
accordance with the Manufacturers Recommendations?
Yes
Go to
2.12
No
Go to
2.13
2.12 Control Measures
Repair or replace faulty or damaged equipment
Portable Appliance Testing carried out
Fixed installations periodically inspected and tested
Suitable policy regarding the use of personal electrical appliances
Ensure all fuses are the correct rating
Other (state here)
2.13 Are inspection lamps or extension leads used?
Yes
Go to
2.14
No
Go to
2.15
2.14 Control Measures
Ensure extension leads are fully uncoiled
Limit extension leads and adaptors
Ensure extension leads are not overloaded
Suitable guards are covering inspection lamps
Ensure flexible power cables are kept as short as possible and safely routed
Other (state here)
2.15 Is Arson a potential problem?
2.16 Control Measures
Yes
Go to
2.16
No
Go to
2.17
Improve security measures e.g. lighting, cameras
Remove combustible storage / waste bins from perimeter of building
Ensure combustible storage is contained with lid secure
Other (state here)
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2.17 Is lightning a potential problem?
Yes No
2.18 Control Measures
Go to 2.18 Go to 3.1
Install lightning protection system
Extend fire detection to cover roof void
Incorporate measures in your emergency plan
Other (state here)
Note any significant findings from section 2:
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3. IDENTIFY PEOPLE AT RISK
3.1 Are there any groups of people at increased risk from fire i.e.
remote areas, lone working, sleeping?
work in
Yes
Go to 3.2
No
Go to 3.3
3.2 Control Measures
Can they be re-located
Improve the means for warning them about fire i.e. alarm and detection system
Improve means of escape
Other (state here)
3.3 Are there people present who may be unable to react quickly to a fire
due to safety critical work process?
Yes
Go to 3.4
No
Go to 3.5
3.4 Control Measures
Introduce appropriate close down procedure
Improve means of warning / means of escape
Other (state here)
3.5 In the event of a fire are there people present whose disabilities
would put them at a disadvantage when required to evacuate in an
emergency?
Yes
Go to 3.6
No
Go to 3.7
3.6 Control Measures
Incorporate Measures in your Emergency Plan
Provide additional specialist equipment
If staff are required to assist in an evacuation ensure sufficient numbers and
appropriate training
Provide safe refuges
Other (state here)
3.7 Are visitors or members of the public likely to be unfamiliar with the
escape routes ?
Yes
Go to 3.8
No
Go to 3.9
3.8 Control Measures
Ensure employees are adequately trained to assist with evacuation
Improve signage
Other (state here)
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3.9 Are builders, contractors or maintenance workers temporarily on
site?
3.10 Control Measures
Yes
Go to 3.10
No
Go to 4.1
Ensure they are aware of fire safety arrangements and emergency plan
Other (state here)
Note any significant findings from section 3:
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