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FIRE RISK ASSESSMENT – Self Assessment

Important! This fire risk assessment form is to be filled in by the responsible person within a business or organisation. As this is a free download for the use of end users, this form must not be used by professional fire risk assessors. This form, while provided free of charge by Safelincs, has NOT BEEN completed by Safelincs! This fire risk assessment form helps to address the majority of fire safety considerations stated in the official fire risk assessment guides related to the Regulatory Reform (Fire Safety) Order 2005. However, before filling in this form you must nevertheless read the relevant fire risk assessment guide(s). This assessment form must be used in conjunction with the official fire risk assessment guide(s)!

There might be fire safety risks not addressed in this form. These risks must be assessed and recorded on separate sheets which must be attached to this form.

If the building is materially altered or the occupancy changes the fire risk assessment must be updated.

Responsible Person

Name of Premises or

Company

Address

Post Code

Telephone No

Name of Assessor(s)

Signature of Assessor(s)

Date of Assessment

Date of Review with

Responsible Person

Building

Property Use

No of floors

No of floors below

ground

Approx area in m2 of footprint

Age of building

of building

Brief details of construction

Building Occupants

Occupancy Profile:

Weekdays

Weekends

Maximum Number of persons, in the

most highly occupied compartment

Are people sleeping in premises?

If so, how many

Description of Occupants:

Atypically mobile for this type of occupancy

Average mobility for this type of occupancy

Predominant Type

Untypically vulnerable for this type of occupancy

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Building Plan

Insert plan of your building here or if you do not possess one, use this space to draw your building floor plan (this does not have to be to scale). Further guidance can be found in Part 1 Section 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.

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.	Yes
paints, thinners, flammable gases etc, flammable chemicals,
plastics, rubber, foams – polystyrene / polyethylene?

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):

	1.2 Are flammable liquids or gases used or stored in areas without		Yes

	adequate ventilation?

Control Measures

Improve ventilation

Other (state here):

1.3 Are there quantities of combustible material stored, on display, or in	Yes
	Yes
use in the premises. E.g. Paper, cardboard, packaging, fabrics,
wood?

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

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Other (state here):

1.4Are quantities of combustible waste allowed to accumulate in the premises such as Paper, cardboard, wood shavings, dust?

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):

Yes

1.5 Does the premises contain foam filled furniture which is not	Yes
combustion modified (see label) or is worn to the point that it exposes the
foam interior?

Control Measures

Replace or repair

Other (state here):

1.6Are 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

Control Measures

Remove

Reduce

Treat with fire resisting solution

Cover

Replace large notice boards with small

Other (state here)

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	1.7 Are combustible seasonal or promotional decorations, artificial foliage or		Yes

	plants used to decorate the premises?

Control Measures

Remove

Treat with fire retardant spray/liquid

Introduce real plants

Replace with non combustible plants

Other (state here):

1.8 Are there additional sources of oxygen stored or used, such as	Yes
oxidising chemicals, oxygen cylinders or piped systems?

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	Yes
cutting, hot surfaces, sparks? Are hazards introduced by outside contractors
and building works?

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)

2.2Does the work activity involve processes such as incinerating or Cooking?

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

Ensure correct type of extinguisher if deep fat fryers are used

Other (state here)

Yes

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Yes

2.3 Are heating appliances portable or of a radiant or open flame type?

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

2.4 Is smoking permitted?

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)

Yes

2.5 Are there light fittings near combustible materials?

Control Measures

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)

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2.6 Is electrical equipment and wiring: Faulty, damaged or not used in	Yes
accordance with the Manufacturers Recommendations?

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)

Yes

2.7 Are inspection lamps or extension leads used?

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)

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2.8 Is Arson a potential problem?

Control Measures

Improve security measures e.g. lighting, cameras

Remove combustible storage / waste bins from perimeter of building

Ensure combustible storage is contained with lid secure

Install anti-arson letterboxes

Train occupants about handling of arson

Ensure that occupants are aware of the alternative exits

Other (state here)

Yes

2.9 Is lightning a potential problem?

Yes

Control Measures

Install lightning protection system

Extend fire detection to cover roof void

Incorporate measures in your emergency plan

Other (state here)

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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. work in		Yes

	remote areas, lone working, sleeping?

	Control Measures

	Can they be re-located
	Can they be re-located

	Improve the means for warning them about fire i.e. alarm and detection
	system

	Improve means of escape
	Improve means of escape

	Other (state here)

	3.2 Are there people present who may be unable to react quickly to a fire		Yes

	due to safety critical work process?

	Control Measures

	Introduce appropriate close down procedure
	Introduce appropriate close down procedure

	Improve means of warning / means of escape

	Other (state here)
	Other (state here)

3.3 In the event of a fire are there people present whose disabilities	Yes
	Yes
would put them at a disadvantage when required to evacuate in an
emergency?

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)

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	3.4 Are visitors or members of the public likely to be unfamiliar with the		Yes

	escape routes ?

	Control Measures

	Ensure employees are adequately trained to assist with evacuation


	Improve signage (Fire Action Signs, escape route signs etc)

	Install maintained emergency exit signs
	Install maintained emergency exit signs

	Ensure escape procedure is explained to visitors

	Other (state here)

3.5Are builders, contractors or maintenance workers temporarily on site?

Yes

Control Measures

Ensure they are aware of fire safety arrangements and emergency plan

Other (state here)

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Note any significant findings from section 3:

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4. MEANS OF ESCAPE FROM FIRE

Yes

4.1 In the event of fire can everyone safely escape from the premises?

Control Measures

Ensure existing exit routes and exits are available and unobstructed

Improve fire alarm / detection system

Provide additional routes and exits

Provide training for safe evacuation

Secure reasonable arrangements for disabled occupants

Implement routine checks

Other (state here)

4.2In the event of fire can everyone turn their back on the fire and evacuate to a place of safety?

Yes

Control Measures

Provide additional escape routes

Provide and maintain protected routes

Provide compensating features i.e. smoke detection, engineer solution

Other (state here)

4.3Do doors on escape routes, where necessary, open in the direction of travel?

Yes

Control Measures

Reduce number of people using exit to less than 60 people

Re-hang in direction of travel

Other (state here)

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4.4Are door fastenings on exit routes and final exits easily operable?

Control Measures

Replace with a more suitable fastening

Provide notices giving information on how to operate exit doors

Provide training on operating techniques Other (state here)

Yes

4.5Is there a need for additional fire doors?

Control Measures

Install fire doors (specify where and the rating)

Fit surface mounted fire door seals (secify intumescent or intumescent/smoke)

Other (state here)

Yes

4.6Are any fire doors a poor fit or requiring fitment or attention to a self closing mechanism?

Yes

Control Measures

Fit self closers

Ensure doors fit correctly

Implement routine check on door operation and maintain as required

Other (state here)

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	4.7 Are any of the fire door intumescent or intumescent/smoke seals missing or		Yes

	damaged?

	Control Measures

	Replace fire door seals

	Fit surface mounted fire door seals (specify intumescent or

	intumescent/smoke)
	intumescent/smoke)

	Other (state here)

Yes

4.8 Are any fire doors wedged or propped open?

Control Measures

Remove any wedges etc

Install Fire Door Retainers to hold open doors legally

Explain fire doors and the need to allow them to close to occupants

Other (state here)

Yes

4.9 Are all exit routes and exits adequately signed ?

Control Measures

Install sufficient signs to enable people to find their way out

Ensure signs are unobstructed and clearly visible from an appropriate distance

Other (state here)

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4.10 Are all exit routes and exits adequately illuminated?

Control Measures

Install emergency lighting

Improve existing emergency lighting

Other (state here)

Yes

	4.11 If the building is compartmentalised, are the walls and ceilings of sufficient		Yes

	fire resistance?

	Control Measures

	Carry out detailed survey

	Strengthen fire resistance

	Other (state here)

4.12If the building is compartmentalised, are there openings that could allow the spread of fire between compartments?

Yes

Control Measures

Seal openings

Install passive fire protection

Other (state here)

4.13Are there structural features that could promote the spread of fire and therefore affect escape routes. Eg open plan floors?

Yes

Control Measures

Compartmentalise

Create additional escape routes

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Other (state here)

Compliance Section 4

Indicate the preventative and protective fire safety measures taken to show compliance with Part 2 of the Order for Emergency routes and exits.

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5. FIRE FIGHTING AND FIRE DETECTION

	5.1 Are there sufficient extinguishers and hose reels of the appropriate		Yes

	type for the risk and are they located correctly?

	Control Measures

	Provide suitable additional fire fighting equipment including specialist
	equipment for special hazards

Locate on stands or brackets

Make visible and unobstructed

Provide additional signage

Other (state here)

	5.2 Are inspection labels on fire fighting equipment in date? Where self-		Yes
	maintained portable fire extinguishers are installed, is there an inspection

	record?

	Control Measures

Carry out service/inspection of fire fighting equipment

Other (state here)

5.3Have sufficient people been trained in the use of fire fighting equipment?

Control Measures

Implement training programme

Other (state here)

Yes

5.4In the event of fire are there suitable arrangements for giving warning, including where necessary automatic fire detection?

Yes

Control Measures

Install a more effective fire alarm system and or detection system

Other (state here)

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	5.5 Does the automatic fire detection system comply with industry guidelines for		Yes
	this type of building/occupancy? (Specify current arrangements in the		Yes

	compliance field at the end of section 5)

Control Measures

Install a more effective fire alarm system and or detection system

Other (state here)

5.6Is the signage for the fire fighting equipment and fire alarm satisfactory?

Control Measures Improve signage

Other (state here)

Yes

5.7Are all appropriate persons trained on how to operate the fire warning system and the action they should take upon hearing it?

Yes

Control Measures

Implement training programme

Provide clear instructions

Other (state here

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Compliance Section 5

Indicate the preventative and protective fire safety measures taken to show compliance with Part 2 of the Order for Fire fighting and Fire detection.

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6. PROCEDURES, ARRANGEMENTS AND TRAINING

6.1	Are sufficient person(s) available to assist in implementation of fire	Yes	No
6.1
	safety measures?

6.2	Are appropriate fire procedures in place, recorded and available for	Yes	No
6.2
	relevant persons to read?
	relevant persons to read?

6.3	Are people nominated to respond to fire and assist with evacuation?	Yes	No
6.3

6.4	Is there appropriate liaison with the Fire and Rescue Authority?	Yes	No



		Yes	No
6.5	Are routine in-house inspections of fire precautions undertaken?

6.6	Are new employees, tenants or building users given fire safety instruction on	Yes	No
6.6
	induction or taking over use of the premises?
	induction or taking over use of the premises?

		Yes	No
6.7	Are all staff given periodic refresher training at suitable intervals?

		Yes	No
6.8	Are building occupants aware of specific actions if there is a fire?

6.9	Are staff with special responsibilities e.g. Fire Marshals/Wardens/stewards	Yes	No
6.9
	given additional training?

6.10 Have the Employers of contractors working at the premises ie. cleaners		Yes	No

	been informed of significant findings and fire procedures?
	been informed of significant findings and fire procedures?

6.11 Are persons under 18 employed, if so has an assessment been made of risks		Yes	No
	special to them and have their parents been informed of significant findings	Yes	No

	and fire procedures?

		Yes	No

6.12 Are fire drills carried out at appropriate intervals?

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Indicate any deficiencies in this section :-

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7. MAINTENANCE AND TESTING

7.1 Are the premises adequately maintained?

Yes

Control Measures

Correct any deficiencies and implement maintenance programme

Other (state here)

Yes

7.2 Are door fastenings on all exit doors adequately maintained?

Control Measures

Correct any deficiencies and implement maintenance programme

Other (state here)

Yes

7.3 Do all self closing devices and hold open devices work correctly?

Control Measures

Correct any deficiencies and implement maintenance programme

Other (state here)

	7.4 Has the emergency lighting system been tested and serviced (Monthly,		Yes

	Six-monthly, Annually) and according to manufacturers instructions?

	Control Measures

	Correct any deficiencies and implement maintenance programme

	Other (state here)

7.5Has the fire alarm / detection system been regularly tested and serviced (Weekly, Annually) and according to manufacturers instructions?

Yes

Control Measures

Correct any deficiencies and implement maintenance programme

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	Other (state here)
	Other (state here)

7.6	Have all fire extinguishers and hose reels been regularly inspected and	Yes
	Serviced (Monthly, Annually) in accordance to manufacturer’s
	instructions?

	Control Measures

	Correct any deficiencies and implement maintenance programme


	Other (state here)


7.7	Has the sprinklers and fixed fire fighting systems been regularly tested	Yes
	and serviced (Weekly, Quarterly, Six-monthly, Annually) and according
	to manufacturers instructions?

	Control Measures

	Correct any deficiencies and implement maintenance programme

	Other (state here)
	Other (state here)

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Compliance Section 7

Indicate the preventative and protective fire safety measures taken to show compliance with Part II of the Order for Maintenance.

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8. FIRE SAFETY RECORDS

8.1	Have fire safety arrangements been recorded in a way that can be easily	Yes	No
	interpreted?

8.2	Are there details of any significant findings from the fire risk assessment	Yes	No
	and any actions taken?
	and any actions taken?

8.3	Are there records of testing and checking of escape routes, including	Yes	No
	final exit locking mechanisms such as panic devices, emergency exit
	devices and any electromagnetic devices?
8.4	Are there records of testing and maintenance of emergency lighting?	Yes	No


8.5	Are there records of testing and maintenance of fire alarm / detection	Yes	No
	systems?

8.6	Are there records of false fire alarms?	Yes	No


8.7	Are there records of testing and maintenance of fire extinguishers, hose	Yes	No
	reels and sprinkler systems etc.?

8.8	Are there records of relevant training of employees including evacuation	Yes	No
	drills?
	drills?

8.9	Are there records of emergency plans and actions for the relevant people	Yes	No
	to take in the event of fire?

Indicate any deficiencies in this section

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Significant Findings (filled in by Assessor)

Item

Section

and Sub

Paragraph

Description of Unsatisfactory Condition

Proposed Remedial Action.

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Review of the Significant Findings –Remedial Action (to be filled in by Responsible Person after Assessment)

Date

Item

Section

and Sub

Paragraph

Remedial Action agreed

By when?

Who is responsible

for Action?

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Question	Answer
Form Name	Fire Assessment Self Form
Form Length	31 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	7 min 45 sec
Other names	fire risk assessment self, fire self assessment, self certify fire risk, self assessment fire risk assessment

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