ICF Life Safety Walk Through Checklist
Location being surveyed
Park West A1
Park West A2
Park West A3
Park West B1
Park West B2
Park West B3
Park West C2
Park West C3
Park West office
Johnstown
Date of mock survey completion
-
Month
-
Day
Year
Date
WALK THROUGH OBSERVATIONS--COMPLIANT Y OR N? N=needs corrected
Yes
No
n/a
All exits free of obstruction
All exit lights and emergency lights work properly
No combustible materials present
No holes or penetrations in walls or ceilings
No doors propped open
Mechanical rooms free from hazards or obstructions
Oxygen signs clear, posted on doors if oxygen present
All sprinkler heads have 18 inch clearance
Closets do not have any items above 18 inch lines
Fire pull stations operational and without obstructions
Outside areas free from smoke hazards and cigarette butts
Fire doors function properly and without obstructions
No extension cords present
Outlets in good condition, no wiring exposed, covers in place
MSDS present for all chemicals
Oxygen stored upright properly in room; marked empty/full
All window coverings and blinds in good condition
Sprinkler heads free from dust and debris
Smoking policy enforced and designated areas noted
ALL furniture in good condition; no dresser knobs missing,
and functions properly
Electrical panel in good working condition and free from obstruction
ALL EXIT DOORS are ONE-RELEASE
FLOOR VENTS FREE OF DEBRIS AND LITTER
Detailed Notes on requirements listed above:
Any other concerns noted?
Name of person completing mock survey:
First Name
Last Name
Email of person completing mock survey:
example@example.com
Submit
Should be Empty: