FIRE SAFETY SURVEY 2000 LIFE SAFETY CODE Worksheet for ... - in-2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the resident's name, your name as the rater, and the facility details at the top of the form.
3. Fill in the date and any explanatory remarks you wish to include in the designated area.
4. On Side 2, assess each risk factor by checking the appropriate circle that best describes the resident. Ensure you write down scores in the provided boxes.
5. For 'Response to Fire Drills', record three checked scores in their respective large circles and sum them up in the designated box.
6. Finally, sign and date where indicated for both surveyor and fire authority official before submitting your completed worksheet.

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