Long Blank FRA Template PDF
Long Blank FRA Template PDF
Long Blank FRA Template PDF
Building Name & Use: Address: Postcode: Name of person(s) with fire safety duties: Name and contact details of assessor: Date of Assessment: Assessor signature:
STEP 1
Refer to Part One of the relevant Fire Safety Risk Assessment guide (see list on back page) Sources of ignition, eg, electrical fittings, smoking, heating, open flames
Action required (Please tick) If you answered YES, record Action Points at STEP 4 Sources of fuel, eg, furniture, textiles and fabrics
YES
NO
Action required (Please tick) If you answered YES, record Action Points at STEP 4 Sources of oxygen, eg, ventilation
YES
NO
Action required (Please tick) If you answered YES, record Action Points at STEP 4
YES
NO
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STEP 2
Refer to Part One of the relevant Fire Safety Risk Assessment guide List all persons potentially at risk from fire, including employees, tenants, visitors and contractors
Action required (Please tick) If you answered YES, record Action Points at STEP 4
YES
NO
STEP 3
Refer to Part One of the relevant Fire Safety Risk Assessment guide Likelihood of a fire starting
Action required (Please tick) If you answered YES, record Action Points at STEP 4 Evaluate the risk to people
YES
NO
Action required (Please tick) If you answered YES, record Action Points at STEP 4
YES
NO
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STEP 4
Refer to Part One of the relevant Fire Safety Risk Assessment guide Fire Safety policy (For further guidance on Fire Safety Policy See Part Two of guide)
Action required (Please tick) If you answered YES, record Action Points at STEP 4 Emergency fire action plan
YES
NO
Action required (Please tick) If you answered YES, record Action Points at STEP 4 Fire safety information and training
YES
NO
Action required (Please tick) If you answered YES, record Action Points at STEP 4
YES
NO
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STEP 4
Refer to Part One of the relevant Fire Safety Risk Assessment guide Fire drills
YES NO Action required (Please tick) If you answered YES, record Action Points at STEP 4 Maintenance of safety measures (For further guidance see Appendix A of relevant Risk Assessment guide)
Action required (Please tick) If you answered YES, record Action Points at STEP 4 Recording information and keeping records
YES
NO
Action required (Please tick) If you answered YES, record Action Points at STEP 4
YES
NO
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Action required (Please tick) If you answered YES, record Action Points at STEP 4 R Equipment, machinery and electrical
YES
NO
Action required (Please tick) If you answered YES, record Action Points at STEP 4
YES
NO
Action required (Please tick) If you answered YES, record Action Points at STEP 4
YES
NO
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Action required (Please tick) If you answered YES, record Action Points at STEP 4 Deliberate fire setting
YES
NO
Action required (Please tick) If you answered YES, record Action Points at STEP 4
YES
NO
Action required (Please tick) If you answered YES, record Action Points at STEP 4
YES
NO
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Action required (Please tick) If you answered YES, record Action Points at STEP 4
YES
NO
Action required (Please tick) If you answered YES, record Action Points at STEP 4
YES
NO
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Action required (Please tick) If you answered YES, record Action Points at STEP 4
YES
NO
Action required (Please tick) If you answered YES, record Action Points at STEP 4
YES
NO
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Action required (Please tick) If you answered YES, record Action Points at STEP 4
YES
NO
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The assessor completing the following section should prioritise remedial measures, based on the level of risk. Priority ratings and suggested timescales: Low (L) 3 6 months Medium (M) Up to 3 months High (H) As soon as possible
STEP 4
ACTION POINTS
Priority Person responsible Completion date
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Review the fire risk assessment if there is a reason to suspect it is no longer valid or if there has been a significant change in the matters to which it relates Reference Part One of the relevant sector specific, fire safety risk assessment guide
STEP 5
Review date
ASSESSMENT REVIEW
Review by
Outcomes of review
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Adapted from original materials created by the Scottish Centre for Healthy Working Lives and the Scottish Fire and Rescue Services
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