Page 1 of 5
Element Yes No N/A Comments/Hazards
Y = Up to standard (adequate), N = Below standard (action required), N/A = Not Applicable
1. Fire Life Safety
1.1 Is emergency lighting operational?
1.2 Are re exits/doors in good condition, operable, unobstructed
and not held open?
1.3 Are re door automatic closing devices operational?
1.4 Are re stairs free of obstructions?
1.5 Are emergency exits appropriately signposted?
1.6 Are written emergency procedures posted and clearly visible to
occupants?
2. Fire Extinguishers, Hose Reels And Hydrants
2.1 Are all extinguishers in place?
2.2 Are extinguishers, hose reels and hydrants accessible and
signposted?
2.3 Do all extinguishers, hose reels and hydrants have inspection
tags, which have been stamped in the last six months?
2.4 Do all hydrant outlets have secure caps?
Completing this Form
Regular loss prevention inspections are a key element of a comprehensive property risk management programme. This form should
be completed during physical site inspections and a copy retained for reference.
Building
Inspected By
Signature
Date
Building Self-Inspection
Checklist
Page 2 of 5
Element (continued) Yes No N/A Comments/Hazards
Y = Up to standard (adequate), N = Below standard (action required), N/A = Not Applicable
3. Fire System Isolations and Faults
3.1 Are the re indicator panel (FIP) and/or EWIS panels free of
isolations and faults?
3.2 Are the re pumps (sprinklers and hydrants) free of isolations/
faults and in auto start mode?
3.3 Are all re pump suction and discharge valves open?
3.4 Are the re pump, FIP, EWIS and sprinkler system logbooks up
to date?
3.5 Are all reported faults being actioned?
Note: Use the Chubb Insurance Fire Protection Impairment Notication Form to report faults and isolations where applicable.
4. Sprinkler System
4.1 Are sprinkler system stop valves secured in an open position?
4.2 Is a stock of replacement sprinklers available on site?
4.3 Are sprinkler heads throughout the building free of corrosion,
mechanical damage or paint?
4.4 In storage areas, is there at least a 500mm vertical gap between
sprinkler heads and storage?
5. Automatic Fire Detection
5.1 Are all smoke detectors and re alarms operational?
5.2 Are all smoke detectors and re alarms free of obstructions?
6. Housekeeping
6.1 Are all areas free of trip hazards (cables, hoses, unmarked
steps etc.)?
6.2 Are all oors, steps and stairs in good condition?
6.3 Are cleaners utilising wet oor signage when cleaning?
6.4 Are entrances provided with wet weather mats?
6.5 Are electrical cupboards/rooms free of combustible storage?
6.6 Are all electrical cable penetrations in electrical cupboards/
rooms/risers sealed with appropriate re retardant materials
(not foam)?
6.7 Are all plant areas free of combustible storage and locked?
6.8 Is the re control room free of storage and locked?
6.9 Are common areas free of accumulated garbage?
6.10 Are all internal lights working correctly?
6.11 Are all external lights working correctly?
Page 3 of 5
Element (continued) Yes No N/A Comments/Hazards
Y = Up to standard (adequate), N = Below standard (action required), N/A = Not Applicable
7. Electrical Safety
7.1 Are portable electrical equipment test tags current?
7.2 Are all electrical outlets, junction boxes and other electrical
boxes properly covered?
7.3 Are all electrical cupboards/rooms/risers locked?
7.4 Are any extension cords being used instead of xed
building wiring?
8. Smoking
8.1 Are designated smoking areas kept clear of ammable/
combustible materials?
8.1 Is there evidence of smoking in ‘non-smoking’ areas?
9. Carparks
9.1 Is speed restriction signage clearly visible?
9.2 Are trac direction markings clearly visible?
9.3 Is carpark clearance height clearly signposted?
9.4 Are wheel stops highlighted?
9.5 Are bollards and columns highlighted?
9.6 Are pedestrian crossing signage and markings clearly visible?
9.7 Is carpark lighting operational?
9.8 Are carpark surfaces free of potholes?
9.9 Are carpark surfaces free of oil spills?
10. Garbage Rooms
10.1 Is an operational fusible link tted to the closure at the base of
the garbage chute?
10.2 Are appropriate re extinguishers readily available?
10.3 Is the garbage room clean and tidy?
11. Commercial Kitchens
11.1 Are kitchen range hoods, ductwork and lters clean?
11.2 Are sprinkler heads in range hoods free of grease
build-up?
11.3 Are appropriate re extinguishers and re blankets readily
available?
11.4 Are gas shut-o valves for kitchen appliances readily accessible
and labelled?
Page 4 of 5
Element (continued) Yes No N/A Comments/Hazards
Y = Up to standard (adequate), N = Below standard (action required), N/A = Not Applicable
12. Dangerous Goods Storage
12.1 Are pool chemicals securely stored?
12.2 Are ammable liquids (paints, fuel etc.) appropriately stored?
13. Swimming Pool and Spa Areas
13.1 Are any climbable objects located near the pool fence?
13.2 Is the pool gate handle operating correctly?
13.3 Does the pool gate fully close and latch automatically?
13.4 Has the pool water been tested within the last week?
13.5 Are pool rules and CPR signage clearly visible?
13.6 Are water depth markings clearly visible?
13.7 Are pool/spa suction ttings and plumbing grates/covers
securely in place and in good condition?
13.8 Does the spa emergency shut-o operate correctly?
14. Gymnasiums
14.1 Is ym equipment instructional signage clearly visible?
14.2 Is any ym equipment defective?
14.3 Is an operational emergency call point installed?
14.4 Is the area free of trip hazards (e.g. free weights, power leads)?
15. Balustrades and Handrails
15.1 Is there any damage to balustrades and handrails?
15.2 Are any climbable objects located near balustrades
or handrails?
16. General
16.1 Are there any indications of overcrowding?
16.2 Are any contractors working on site?
16.3 If so are appropriate management procedures (eg. Hot work)
being followed?
16.4 Is there any evidence of forced entry or malicious damage?
16.5 Are all CCTV cameras operational?
Note: Use the Chubb Insurance Hot Works Permit for any hot works where applicable.
Page 5 of 5
Chubb Building Self-Inspection Checklist, Australia. Published 09/2019.
©2019 Chubb Insurance Australia Limited. Chubb®, its logos, and Chubb.Insured.
SM
are protected trademarks of Chubb. Chubb15280919
About Chubb in Australia
Chubb is the world’s largest publicly traded property and casualty insurer. With operations in 54 countries and territories, Chubb
provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance,
reinsurance and life insurance to a diverse group of clients. As an underwriting company, we assess, assume and manage risk with
insight and discipline. We service and pay our claims fairly and promptly. The company is also dened by its extensive product
and service oerings, broad distribution capabilities, exceptional nancial strength and local operations globally. Parent company
Chubb Limited is listed on the New York Stock Exchange (NYSE: CB) and is a component of the S&P 500 index. Chubb maintains
executive oces in Zurich, New York, London, Paris and other locations, and employs more than 30,000 people worldwide.
Chubb, via acquisitions by its predecessor companies, has been present in Australia for 100 years. Its operation in Australia (Chubb
Insurance Australia Limited) provides specialised and customised coverages, including Business Package, Marine, Property,
Liability, Enery, Professional Indemnity, Directors & Ocers, Financial Lines, Utilities, as well as Accident & Health insurance, to
a broad client base, including many of the country’s largest companies. Chubb also serves successful individuals with substantial
assets to protect and individuals purchasing travel and personal accident insurance. With ve branches and more than 800 sta in
Australia, it has a wealth of local expertise backed by its global reach and breadth of resources.
More information can be found at www.chubb.com/au.
Contact Us
Chubb Insurance Australia Limited
ABN: 23 001 642 020 AFSL: 239687
Grosvenor Place
Level 38, 225 George Street
Sydney NSW 2000
O +61 2 9335 3200
F +61 2 9335 3411
www.chubb.com/au
Element (continued) Yes No N/A Comments/Hazards
Y = Up to standard (adequate), N = Below standard (action required), N/A = Not Applicable
17.
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