ULM
Environmental Health & Safety Department
Quarterly
Building Inspection Form Instructions
General
Information
The quarterly
building
inspection form is designed to help the person performing the
inspection
identify hazards in the building. All items that appear on the
form
may not be applicable in your particular building, if this is the case
then simply place an "x" in the N/A column. For items that do
apply
to your building, carefully check the items and place an "x" in the YES
or NO section as appropriate. When issues and problems are found
please be sure to use the comments section of the form to specifically
identify the problem. The specific location and a good
description
of the problem are extremely helpful in getting the problem addressed.
If a work order has been issued to correct the problem, please note the
work order number in the comment section.
For more specific
information on what each question in the form is about please see the
following
below:
Fire
Safety Conditions
General
Building Safety Conditions
Electrical
Safety Conditions
Other
Building Safety Issues & Concerns
Fire
Safety Conditions
- Are all fire
extinguishers
in place, fully charged, and checked monthly?
- Check all
fire
extinguishers
in the building to make sure that they are there. Document any
missing
fire extinguishers in the comments section
- Check each
fire exinguisher
to ensure that it is fully charged. You can do this by viewing
the
guage that is on most fire extinguishers. The needle on the guage
should be pointing in the middle of the range. Please document in
the comments if the needle is not in the normal range.
- Check each
fire extinguisher
to ensure that the fire extinguisher monthly inspection tag is
correctly
completed.
- Are fire
exinguisher
inspection tags in place?
- Annual
Fire
Extinguisher
Inspection Tag - this tag will state at the top "DO NOT REMOVE BY ORDER
OF THE STATE FIRE MARSHAL". Check the tag to ensure that it has
been
inspected within the past year. This inspection must be performed
by a licensed contractor.
- Monthly
Inspection Tag
- check this tag to ensure that building personnel are inspecting fire
extinguishers on a monthly basis.
- Is the fire
alarm system
functioning properly and has it been tested within the past year?
- Unless you
know of any
problems with the fire alarm system then it is probably functioning
correctly.
It is not necessary to sound the fire alarm during each building
inspection.
- Look near
the
alarm
control panel or on the panel for the inspection tag. This
inspection
tag is issued by a licensed contractor and performed annually.
Check
to ensure that it is still within date.
- While you
are
at the
alarm control panel look at it and make sure that there are no obvious
trouble signals (i.e. trouble lights, visual or audible warnings, etc.)
- Are smoke
alarms
functioning
correctly?
- Test each
smoke alarm
in the building by pushing the test button on the smoke alarm until the
smoke alarm sounds (on some models you have to hold the button in
several
seconds). If alarm does not sound note what you think the problem
is (i.e. no electricity, defective alarm, etc.) Some buildings do
not have smoke alarms, if this is the case check N/A (not applicable).
- Are
emergency
lights
functioning correctly?
- You can
determine this
by pushing the test button on the emergency lights. If the lights
come on then they are functioning correctly. Some buildings do
not
have emergency lights, if this is the case check N/A (not applicable).
- Are all
exits
marked
with exit signs and illuminated by a reliable source?
- Check exit
signs throughout
the building to ensure that they are legible and illuminated.
Report
if any bulbs are out or if lights and/or signs are missing.
- Are
evacuation
plans
posted near doors?
- Each
building
should
have an evacuation plan posted near all doors in the building.
- Are all
doors
and hallways
leading to an exit, free to access with no possibility of being locked
in?
- Check to
make
sure that
no doors leading to an exit are blocked or locked. This will
impede
egress (exit) during an emergency and is not allowed by the fire
marshal.
Check for materials blocking the doors. If doors are locked then
appropriate panic hardware must come on the door that is locked.
This will allow exit in case of an emergency.
- Are exit
routes
kept
free of obstructions?
- Check exit
routes to
ensure that they are kept clear. Exit routes include hallways,
stairways,
entranceways, etc. Please make sure that boxes, desks, trash
cans,
etc. are blocking hallways. This may impede egress in an
emergency
and is not allowed.
- Do exit
doors
open outwards?
Will fire & exit doors close and latch properly?
- All exit
doors
should
open outwards.
- Check fire
doors and
exit doors to make sure they close and latch properly. These type
of doors should have automatic door closers attached to them.
Check
the closers carefully and make sure they are working properly.
Once
the door closes ensure that it latches shut properly. The reason
for doing this is in case of a fire the door will isolate that floor
from
fire and smoke as long as it is closed. Do not allow anyone to
prop
these doors open.
- Has a fire /
evacuation
drill been conducted within the past year?
- A new
requirement issued
by ORM is that all of our buildings conduct a fire drill at least once
per year. The fire drill should be documented on the fire drill
form.
During the quarterly inspections check your records to ensure that your
building is not due for a fire drill. See the fire drill section
of this site for more information before conducting a fire drill.
- Are there any
portable
heaters present in the building?
- Check
rooms
and offices
of the building to ensure that no portable heaters are present.
If
portable heaters are found please note that on the form. Make
sure that the heater conforms to the Portable Heater Policy. If
not, politely
ask the owner of the heater to remove the heater from the
building.
- Are emergency
phone
numbers posted on all phones in the building?
- Check
phones,
especially
department office and other public phones to ensure that emergency
phone
numbers are posted on the phone. This would include 911 and
campus
police number x-1911
- Are there any
first aid kits in the building? Inventory card current?
Location._______________
a. Check the first aid kits
with in your building. Make sure that each kit is has an
inventory card listing all
the supplies. Make sure each kit has been
checked monthly.
b. Make sure there are no
medications (Tylenol, antacids, etc.) in the kits. Burn ointment is
acceptable.
c. Make sure that none of
the supplies are expired.
General
Building Safety Conditions
- Are there
any
slip /
trip / fall hazards located inside or outside of the building?
- Slips,
trips,
and falls
are the most common types of accidents. Check the building and
the
outside areas of the building for any conditions or hazards that might
cause slips, trips, and / or falls.
- In areas that
stay wet,
greasy, or slippery are floor mats or other anti-slip material used?
- Note any
areas
that
are wet, greasy, or otherwise slippery. These areas should have
floor
mats or other anti-slip material. Common problem areas
include:
entranceways, halls, and stairs (due to wet weather), kitchen &
food
preparation areas (due to grease), maintenance areas (due to oil &
other fluids), etc.
- Are service
holes, man
holes, drains, etc. properly covered?
- Look at
the
outside
grounds of the building and make sure that all drains, service holes,
man
holes, etc. are properly covered to keep pedestrians from accidentally
stepping into these holes.
- Is the
building well
lit, inside and outside?
- Check the
building lights
carefully to determine if any bulbs need replacing. Lights inside
and outside of the building should be checked.
- Is
housekeeping in the
building adequate?
- Check to
make
sure that
the housekeeping in the building is adequate. Building should be
cleaned regularly, material should be stored in proper locations,
garbage
emptied regularly, areas free of debris and clutter, etc.
- Are floors in
good condition
with no loose or broken flooring?
- Check
floors
carefully
to make sure that flooring is in good condition with no loose or broken
flooring.
- Are stairways
in good
condition with handrails in place? Are stair treads in good
condition?
- Check all
building stairways,
check for loose handrails, and check to make sure stair treads are in
good
condition (i.e. there is still tread, it is not breaking loose, etc.)
- Does the
building have
any pest problems?
- Please
list
any pest
problems in your building. Be specific as possible. Also
note
the last time the building was treated for pests if known.
- Are all
ceiling tiles
in place and in good condition throughout the building?
- Check all
ceiling tiles
and report any broken or damaged tiles on the inspection report.
- Is the
building secure?
Are all outside doors locked at the end of each day? Are all
locks
and other security devices working properly?
- Check to
make
sure that
all outside doors are locked at the end of each day. Also check
each
door in the building to make sure that locks and other security devices
are functioning properly.
- If equipped,
is the
security system for the building working properly?
- Report any
problems
or issues with the security system if your building has one. If
your
building does not have a security system, mark this item N/A.
- Are all
maintenance
and mechanical areas secure?
- Check all
maintenance
& mechanical areas (boiler room, air handler, sprinkler room, etc.)
and make sure they are locked except when authorized personnel are in
these
areas.
- Are all
custodial areas
in good condition? Are all chemicals stored properly with no
overstocking?
Is this area secure?
- Check the
custodial
areas to make sure that they are well kept. No excess chemicals
should
be stored, only what is needed. Make sure the area is secure and
that only authorized personnel can access these areas.
- Do any windows
have
broken panes? Do windows open & close correctly?
- Check all
windows in
the building to make sure that none of the panes or glass is broken or
cracked.
- For
windows
that are
supposed to open make sure that they open, close, and latch correctly.
- Are all
elevators working
correctly? Are elevators equipped with an emergency phone?
- Check each
elevator
in the building to make sure it is working correctly. Check to
make
sure that on each floor the elevator is stopping level. Make sure
that the all of the elevator buttons function correctly. For
elevators
operated by keys check to see if the key hole can be turned by any
key.
Check each elevator to make sure that it has an emergency phone and
that
this phone is working properly.
- Is the parking
lot in
good condition?
- Check the
parking lot
to make sure that no major potholes are present. Check to make
sure
parking lines are visible, handicapped spaces are marked, etc.
- Are there any
water
leaks in the building?
- Note the
exact
location
of any water leaks in the building. When looking for leaks look
for
wet ceiling tiles, wet walls, areas of mold & mildew, etc.
- Are all
plumbing systems
working properly?
- Note any
plumbing problems
in the building (i.e. clogged drains, flushing problems, drain leaks,
potable
water leaks, sink leaks, etc.
- Check that the Hazard
Control log is complete and posted on the safety bulletin board.
If
any hazards are reported, then
the building safety coordinator will arrange for corrective actions to
begin so that the hazard can be corrected. If deemed appropriate,
then corrective action must be initiated as soon as possible or at
least
within thirty days. As necessary each hazard control log should
be replace with a new log. The old log should be mailed to the
Environmental Health and Safety office.
- Check
the
safety bulletin
board to ensure the following are posted: president's policy
statement,
asbestos notice, natural gas notice, emergency numbers, whistleblower
protection
Electrical
Safety Conditions
- Are all
breaker
boxes
and junction boxes properly labeled? Are empty breaker slots
covered
(no blanks)? Do the box doors close properly?
- Check to
make
sure that
each breaker in the box is properly labeled as to its function.
- Make sure
that
any empty
slots in the breaker box are covered with metal inserts
- Make sure
the
box doors
close and latch properly
- Check
extension
cords
- Check to
make
sure extension
cords are properly grounded (look for the three prong plugs on each end
with the third plug made for grounding purposes)
- Is the
extension cord
adequately sized for the current being drawn? This will depend on
what the extension cord is powering. Question extension cords
that
are powering many devices or large electrical devices. In these
scenarios
you may want to consult an electrician to determine if the electrical
load
is too great for the extension cord. Feel the cord and see if it
is hot, this is an indication that the cord is overloaded.
- Check the
cords for
damage, make sure the insulation is intact, the cord has not been
melted,
cut, or frayed in any way.
- Check to
ensure that
the cords are placed in a manner to prevent tripping. Cords
should
be out of heavy traffic areas and may need to be taped or secured to
the
floor to prevent tripping. Rubber cord guards can also be used.
- Are there
any
exposed
wires, frayed cords or wires, torn or frayed insulation, loose or
broken
conduit, etc.?
- Check the
building completely
and report any of the conditions listed above. Any exposed
wiring,
torn wiring, broken conduit, torn or frayed insulation can present
significant
hazards.
- Are junction
boxes,
outlets, switches, fittings, etc., covered an in good condition?
- Check all
outlets, switches,
boxes, fittings, etc. and make sure that covers are in place and in
good
condition. Report any and all missing or damaged covers.
Other
Building Safety Issues and Concerns Noted by the Inspector
While conducting
these inspections there will be many instances when you see something
that
you think is unsafe but it is not on this inspection form. Just
because
it is not a question on the inspection form does not mean it is not
important.
This section of the form is intended to note such items. List the
item (specific location if applicable) and in the comments portion list
the issue or problem. If it is necessary you can continue on the
back of the form or on a separate sheet of paper.
<>Environmental
Health & Safety Department
The
University of Louisiana at Monroe
700
University Avenue
Monroe,
LA 71209-2800
(318)
342-5177
(318)
342-3465 (fax)
mcnair@ulm.edu