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Application NameSITE_INSPECTION Form NameSITE_INSPECTION_FIRE Form TitleWHS Site Inspection - Fire Form Description

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WHS Site Inspection - Fire Assignment

System Number
Group OrganisationRehab ManagementAimBigLiveBigArriba Corporate	Manager Responsible false100	Site false100	Site Address

WHS Site Inspection - Fire Checklist

Date of Inspection	Inspection Completed Byby the Inspector	Completed Byby the Reviewer
Fire Equipment Service Company(Hint: check the bottom of the Fire Evacuation Plan)

WHS Site Inspection - Fire Safety

Evacuation Plan

1. Emergency evacuation plan is on display at the site:YesNo	Contact maintenance@arribagroup.com.au
Is there a date on the evacuation plan?YesNo
Evacuation Diagram

What is the date on the evacuation plan?

	Attach image of evacuation plan
	Attach image of evacuation plan

Is the date within the last 5 years?YesNo

Contact maintenance@arribagroup.com.au

2. Is there an Emergency Assembly Area?YesNo

Contact Property Manager for advice at email: maintenance@arribagroup.com.au

3. Emergency assembly area is clearly marked on Evac PlanYesNo

Contact Property Manager for advice at email: maintenance@arribagroup.com.au

Emergency Management Plan

4. Do you have a site-specific Emergency Management Plan in place that has been completed & communicated to all staff?YesNoHint: See the M-0124-LARC Emergency Management Plan.docx

Download Template and complete for site - make accessible to all staff.

M-0124-LARC Emergency Management Plan.docx

5. The workplace – Emergency Response Information/ Flip Book is accessible, completed and has been communicated to all staff?YesNoHint: See Link to Template

Download Flipchart template from this Link, Complete site details, and place somewhere visible and accessible.

Template

Emergency Evacuation Drill

6. Has an Emergency Evacuation Drill been conducted in the last 6 months?YesNo

Conduct Emergency Evacuation Drill immediately / Contact whs@arribagroup.com.au for more.

Date of the last Emergency Evacuation Drill

Is there a completed Emergency Observation and Debrief Form in the last 6 months?YesNo

Complete Emergency Observation & Debrief Form and send to whs@arribagroup.com

	Attach Emergency Observation & Debrief Form
	Attach Emergency Observation & Debrief Form

Fire Equipment

7. Fire Equipment (Fire extinguishers, blanket, hose reel) has been serviced in the past 6 months (check service tag)YesNo(Hint: see image below) - Attach image of fire tag with date stamp circles	Contact maintenance@arribagroup.com.au
Fire Equipment

	8. Attach photo of service tag from fire equipment (Extinguisher)
	8. Attach photo of service tag from fire equipment (Extinguisher)

9. Are Fire Extinguishers easily accessible?YesNo

Remove clutter from around fire equipment to ensure equipment is accessible.

10. Fire blanket appropriately located and easily accessible. (where open flame cooking appliances)YesNo

Contact maintenance@arribagroup.com.au

11. All fire equipment is clearly marked with signs in the workplace (fire extinguishers, blankets, hose reel)YesNo

Contact maintenance@arribagroup.com.au

Emergency Exits

12. Exit Sign Lights are in working orderYesNo

Contact maintenance@arribagroup.com.au

13. Exit doors can be easily accessed (i.e. no clutter in front of exit doors)YesNo

Remove clutter from around exit doors to ensure there is a clear pathway to exit the site

14. Smoke detectors are in working order (i.e. light flashing indicating battery has charge)YesNo

Contact maintenance@arribagroup.com.au

Fire Warden

15. How many Arriba Group staff are located at the site?

16. Are there any trained Fire WardensYesNo

Appoint Fire Wardens (Hint: there should be at least one Fire Warden on site each day that staff are present in the office)

18. Who are the Fire Wardens for this site?

19. Is there an updated Fire Warden Poster displayed in the workplace?YesNo	Ensure there is a readily visible Fire Warden Poster with picture of Fire Warden in the office
Please attach an image of the Fire Warden Poster.

Notes

ACTIONS TAKEN TO RECTIFY: (PLEASE DETAIL)

Do you have any other safety concerns about this site?YesNo

Please provide details of your concern and upload attachments if needed

	Attachments
	Attachments

Corrective Action(s)

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Date of Assignment

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