Fire Safety Daily Work Report
Complete this form to document your daily fire safety inspections and activities.
Staff Full Name
*
First Name
Last Name
Position/Title
*
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Time of Inspection
*
Hour Minutes
AM
PM
AM/PM Option
Area or Location Inspected
*
Fire Safety Equipment Checklist
*
Rows
Inspected?
Condition
Fire Extinguishers
1
Good
Needs Service
Damaged
Fire Alarms
2
Good
Needs Service
Damaged
Emergency Exits
3
Good
Needs Service
Damaged
Sprinkler Systems
4
Good
Needs Service
Damaged
Emergency Lights
5
Good
Needs Service
Damaged
Were any fire hazards or issues found during inspection?
*
No issues found
Yes, issues found (please describe below)
Description of Hazards or Issues (if any)
Actions Taken or Recommendations
Additional Comments or Notes
Supervisor/Manager Name (if applicable)
Signature of Reporting Staff
*
Submit Report
Submit Report
Should be Empty: