FSE-101
INSPECTION CHECKLISTS
Inspection Record
Name of Facility: ______
Address: ______
City, State, Zip: ______
Inspected by: ______
Date of Inspection: ______
Occupancy Class: ______
Specific Use: ______
No. of Stories: ______
No. of Sub-Levels: ______
Location of Assembly: ______
Floor Area 1st level: ______
Assembly Floor Area: ______
Mixed Occupancy: ______
Roof Covering: ______
Exterior Walls: ______
Interior Walls: ______
Elevator Controls: ______
Interior Finishes: ______
Fire Alarm Type: ______
Manual: ______
Automatic: ______
Voice: ______
Supervised: ______
Annunciated: ______
Fire Detection: ______
Units: ______
System: ______
Heat: ______
Smoke: ______
Exit Doors: ______
Ample #: ______
Width: ______
Height: ______
Swing: ______
Hardware: ______
Panic Bar: ______
Exit Signs: ______
Locked Doors: ______
Fire Doors/unlocked: ______
Rating: ______
Hardware: ______
Frame: ______
Closing Device: ______
Latching: ______
Gasketing: ______
Exit Illumination: ______
Means of Egress: ______
Signs: ______
Emergency System: ______
Separate Power: ______
Separate Circuits: ______
Gen House Circuits: ______
Corridors: ______
Width: ______
Height: ______
Fire Rated: ______
Dead Ends: ______
Stairways and Ramps: ______
Width: ______
Height: ______
Enclosure: ______
Gradient: ______
Landings: ______
Venting: ______
Vestibule: ______
Roof Access: ______
Handrails: ______
Barrier at Exit Discharge: ______
Aisles: ______
Width: ______
Cross Aisles: ______
Sprinklers: ______
FDC: ______
Wet: ______
Dry: ______
Combination: ______
P.I.V.: ______
O.S.&Y.: ______
Test: ______
Standpipes: ______
Wet: ______
Dry: ______
Combination: ______
FD Connection: ______
Hose: ______
Date Last Tested: ______
Other Fire Protection Systems: ______
Type: ______
Location: ______
Condition: ______
Date Last Serviced: ______
Fire Hydrants: ______
Fire Extinguishers: ______
Ample #: ______
Type: ______
Location: ______
Date Last Serviced: ______
Hood Systems: ______
Semi Automatic Inspection: ______
No Grease Accumulation: ______
Heating: ______
Type: ______
Ducts: ______
Dampers: ______
Smoke Detectors: ______
Auto Shut-off: ______
Enclosures: ______
Fuel: ______
Condition: ______
Electrical: ______
Type: ______
Panel/Meter Clear: ______
Circuit Protector: ______
Extension Cords: ______
Grounding: ______
Condition: ______
Housekeeping: ______
Storage: ______
Enclosure: ______
Daily Pick-up: ______
Proper Clearance from Bldg.: ______
Gen. Condition: ______
Flammable & Combustible Liquids: ______
Type: ______
Amount: ______
Separation: ______
Safety Containers: ______
Location: ______
Miscellaneous: ______
Correct Address Posted: ______
Occupancy Load Posted: ______
Fire Lanes Properly Posted: ______
Other Items: ______
______
______
______
Remarks or Summary of Requirements: ______
______
______
______
______
______
Signed: ______
Title: ______
Date: ______
PLACE OF ASSEMBLY
Mixed Occupancies:
Separation by fire resistive construction required?
Openings protected?
Occupant Load:
What is it?
Is it posted?
Is it being exceeded?
Exits:
Required # for occupant load?
Doors swing in direction of travel?
Panic hardware required?
Doors open easily?
Unobstructed?
Aisles:
Sufficient width?
Adequate number?
Exit Lighting:
Is it operable?
Did you test it? Someone else? When?
Exit Discharge:
Do they lead to public ways?
Are they free of storage and debris?
Fire resistive Assemblies:
Are they protected?
Are penetrations for pipes and cables protected?
Fire Dampers and Doors:
Equipped with self-closures or automatic closers?
Are the closures operational?
Do the doors latch when closed?
Are the fusible elements free of paint and corrosion?
Have any closing elements been mechanically bypassed?
Doors wedged open?
Interior Finishes:
Proper flame spread rating for the application?
How about the smoke generation rating?
Decorations:
Noncombustible materials?
Flame-retardant-treated combustibles?
Did you test a sample?
See certification of flame retardant treatment?
Vertical openings:
Are they enclosed by fire-resistive construction?
Fire protection equipment:
Fire extinguishers properly located? Identified?
Last inspected and tested?
Sprinkler valves accessible and open?
Valve supervision operable?
Sprinklers unobstructed and free of foreign matter?
Fire pumps and controls in operating condition?
Theatrical stages:
Proscenium curtain in place?
Automatic venting operable?
Projection rooms:
Supply air and exhaust provisions?
Exhaust facilities for projectors?
Work Space adequate for number of machines housed?
Alarm system:
Manual?
Did you test it? Someone else? When?
Sounds alarm only in monitored location?
Does the public address system work?
Potential source of ignition:
Did you check building services?
Are kitchen hood and exhaust systems clean?
Does exhaust damper work?
Are open flames used?
Cooking and warming carts?
Candles in religious or fraternal ceremonies?
Flames or pyrotechnics in performances?
Temporary electrical connections?
EDUCATIONAL FACILITITIES
Chemical laboratories:
Proper fire extinguisher?
Fire blanket?
Chemicals checked for shelf life and stability?
Seasonable decorations and theatrical sets:
Noncombustible materials?
Flame retardant treated combustibles?
Did you test?
Excessive amount of combustibles?
Doors (child day care centers):
Closet door openable from the inside?
Bathroom doors openable from outside by staff?
Fire doors:
Automatic self-closing?
Held open by approved smoke activated device?
Kitchen:
Exhaust fans clear?
Hoods equipped with extinguishing equipment?
Instructions posted for using extinguishing equipment?
Electrical wiring:
Outlets equipped with protective covers (child day care center)?
Building arrangement:
Grid type layout of corridors and classrooms?
Open plan arrangement?
Workshop:
How are combustible wastes handled?
Are flammables and combustibles liquids stored properly?
Oily rags kept in containers with self-closing covers?
Exit lighting:
Is it operating?
Did you test it? Someone else? When?
Fire alarm system:
Is fire alarm system backed up by a public address system?
Is the system in service?
Vertical opening:
Are they enclosed in fire resistive construction?
Are doors self-closing and do the closures work?
Are there wedges or other devices holding the doors open?
Remodeling:
Has there been any since the last inspection?
Has it affected the means of egress?
Open plan layouts:
Has the layout been changed since the last inspection?
Was the change approved before hand?
Interior Finish:
Have alterations been performed since the last inspection?
Did they affect the class of interior finish?
HEALTH CARE FACILITIES
Stairway doors:
Properly held open?
Close completely?
Positively latch?
Fire exit sign?
Doors to patient’s room:
Latch keeps door tightly closed?
Free from obstruction?
If locks are installed?
Can door be opened from inside by patient without use of key?
Can lock be locked from corridor?
Are keys and tools carried by attendants at all times?
Fire and smoke doors:
Self-closing?
Close completely?
Not improperly held open?
Exits:
Provide free and unobstructed egress?
Aisles, corridors, and ramps clear and unobstructed?
Signs continuously lighted and visible?
Emergency lighting:
Automatic and not manual?
Power source tested weekly? Monthly under load?
Smoking regulation:
Prohibited wherever flammable liquids or gases are stored and used?
Posted no smoking signs?
Prohibited by patients unless supervised?
Noncombustible ashtrays where smoking is permitted?
Self-closing metal containers in smoking areas to empty ashtrays into?
Fire Safety:
Automatic sprinklers tested and maintained?
Main sprinkler control valve electrically supervised with local alarm?
Audible and visual warning devices?
Manual pull stations?
Automatic fire and smoke detectors?
Sprinkler system flow alarm?
Electromagnetic hold open devices?
Direct telephone line and auto dialer?
Annual maintenance of portable fire extinguishers?
BUSINESS FACILITITES
Floor plan:
Open plan layout?
Conventional office cubicles?
Has the floor plan changed since the last inspection?
Is there an atrium?
Is it an old atrium not complying with life safety code requirements?
Means of egress:
Are there two exits remotely located?
Are corridor wall openings adequately protected?
Is emergency lighting adequate?
Is access to exits unobstructed in open plan offices?
Is exit discharge free of obstruction?
Exit Doors:
Are thy properly rated?
Do they latch securely?
Do the self-closures work properly?
Can they be locked from the occupied side?
Can they be locked from the stairway side?
If so are they all locked?
Are there wedges holding doors open?
Computer Rooms:
What is the construction of the computer room?
Is there a raised floor?
Is there a halon total flooding system?
Does it have smoke detectors (in floors or ceiling)?
Are there manual electrical disconnects for all the equipment and the air conditioning systems?
Are there portable fire extinguishers? What kind?
Do you think there is too much paper evidence in the room?
What arrangement is there for storage of extra supplies?
Protection of records:
Does the management have a plan for protection of vital record?
Is there a vault on the premises?
Is the vault ground supported or structure supported?
Is it protected by sprinklers or smoke and heat detectors?
Is there a record storage room for computer tapes, disc, or other valuable paper not requiring a vault?
How is the record room protected?
Are there insulated record containers and safes on the premises?
What is the arrangement for general files (open shelves, metal containers, mobile units)?
Waste Disposal:
Is trash stored outside away from the building in a safe manner?
Is there a storage room or bin inside the building and what is its construction?
Is the storage room sprinkled?
Are there waste chute openings for closing and latch tightly in the closed position?
Any special precautions for emptying ashtrays and receptacles?
Kitchen Equipment:
Are hoods and ducts clean?
Are there special extinguishing systems for hoods, ducts, fat fryers, ranges, griddles, and broilers?
Are the instructions posted on manual operation of the system?
Are there portable fire extinguishers in the kitchen suitable for Class B and C fires?
Fire Protection Equipment:
Are sprinkler valves accessible and open?
When was the system last inspected and tested
Are sprinklers unobstructed and free of foreign matter?
Are fire extinguishers of the proper kind and properly located?