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.

for questions or guidance to go to the Harris County School Safety Toolbox: https://hcfchub.net/school-safety-toolbox/
Submitters Name

TitleFirst NameLast Name
Submitters Email
example@example.com
ISD
School Name
Superintendents Name

TitleFirst NameLast Name
Superintendents Email
example@example.com
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/Life Safety Systems at this facility - Check all that apply.
Fire Sprinkler System - Date of Last Test/Inspection

MonthDayYear
Date
Fire Sprinkler System Tag

Please make sure the date is clearly visible
Cancelof
Fire Alarm System - Date of Last Test/Inspection

MonthDayYear
Date
Fire Alarm System Tag

Please make sure the date is clearly visible
Cancelof
Paint Booth - Date of Last Inspection

MonthDayYear
Date
Pant Booth Tag

Please make sure the date is clearly visible
Cancelof
Portable ABC Extinguishers - Date of Last Inspection

MonthDayYear
Date
Portable ABC Extinguishers Tag

Please make sure the date is clearly visible
Cancelof
Fire Pump - Date of Last Inspection

MonthDayYear
Date
Fire Pump Tag

Please make sure the date is clearly visible
Cancelof
Kitchen Hood System - Date of Last Inspection

MonthDayYear
Kitchen Hoods are required to be inspected at a minumum every 6 months.
Kitchen Hood System Tag

Please make sure the date is clearly visible
Cancelof
Kitchen Hood System - Date of Last Cleaning

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

MonthDayYear
Date
Automatic External Defibrillator (AED) Pads Expiration date

MonthDayYear
Date
Automatic External Defibrillator (AED) Battery Expiration date

MonthDayYear
Date
Submit AED picture showing AED cabinet and status light

In accordance with Texas Education code 37.108 / Texas Health and Safety 779 AED Cabinet is visible, clearly marked, and easily accessible. Cabinet is unlocked or has a breakaway seal. no barriers–Clear signage indicating "AED" present above or near unit. Check status indicator light (usually green = ready with no Error lights or warning messages visible
Cancelof

Does your facility have natural gas service?
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
Submit last Natural Gas Test

Cancelof

In accordance with the adopted fire code (IFC 2021 and approved amendments) and Texas Education Code 37.108, all Multi-hazard emergency operations plan shall be prepared and maintained for school instructional facilities. This plan must be submitted and approved by the Fire Code Official.
Submit Evacuation Drill Records for review and approval - Section 405 IFC 2021

In accordance with Texas Education code 37.108 / IFC 405
Cancelof
Do all classrooms and hallways have clear instructions and maps for evacuation posted?
Submit Multi-Hazard Emergency Operations Plan -Texas Education Code 37.108 / IFC 404

Cancelof

School Self-Assessment

Other Miscellaneous Hazards