School Self-Assessment

School Self-Assessment
In order to serve the schools in unincorporated Harris County, the Fire Marshal’s Office is requiring completion of this self-evaluation form. This form is required to be submitted to the HCFMO no later than April of each school year.
Name

First NameLast Name
Email
example@example.com
ISD
School Name
Facility Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Per the adopted fire code of Harris County, all fire protection systems shall be inspected and tested once per year to ensure that the system is functioning as designed. Please indicate the dates of the last inspection for each system your facility has below.
Fire Protection Systems at this facility - Check all that apply.

Fire Sprinkler SystemFire Alarm SystemPaint BoothPortable ABC Fire ExtinguishersFire PumpKitchen Hood SystemPortable Class K Fire Extinguishers
Fire Sprinkler System - Date of Last Test/Inspection

MonthDayYear
Date
Fire Alarm System - Date of Last Test/Inspection

MonthDayYear
Date
Paint Booth - Date of Last Inspection

MonthDayYear
Date
Portable ABC Extinguishers - Date of Last Inspection

MonthDayYear
Date
Fire Pump - Date of Last Inspection

MonthDayYear
Date
Kitchen Hood System - Date of Last Inspection

MonthDayYear
Kitchen Hoods are required to be inspected at a minumum every 6 months.
Kitchen Hood System - Date of Last Cleaning

MonthDayYear
Date
Portable Class K Fire Extinguishers - Date of Last Inspection

MonthDayYear
Date
Does your facility have natural gas service?

YesNo
The Texas Administrative Code Title 16, Rule 8.230 requires that Public, Charter, and Private Schools shall have a natural gas pressure test once every two years.
Date of last Natural Gas Pressure/Leak Test

MonthDayYear
Date

In accordance with the adopted fire code and Texas Education Code 37.108, all Multi-hazard emergency operations plan shall be prepared and maintianed for school instructional facilties. This plan must be submited and approved by the Fire Code Official.

IFC Harris County Fire Code 2018
Submit Evacuation Drill Records for review and approval - Section 405 IFC 2018*

In accordance with Texas Education code 37.108 / IFC 404
Cancelof
Do all classrooms and hallways have clear instructions and maps for evacuation posted?

YesNo
Submit Multi-Hazard Emergency Operations Plan -Texas Education Code 37.108 / IFC 404*

Cancelof

Other Miscellaneous Hazards