Chipstead PlaceLawn Tennis Club
HS 3.4.4 - Risk self-assessment form for facilities
Club name:____________________________________________________________
Venue: ________________________________________________________________
Name and position of person doing check: __________________________________
Date of check:__________________________________________________________
Playing/training area
Check that the area and surroundings are safe and free from obstacles.
Is the area fit and appropriate for activity?…………………………………..…Yes No
(If no, please outline the hazard, who may be at risk and action taken, if any.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Equipment
Check that it is fit and sound for activity and suitable for age group/ability.
Is the equipment safe and appropriate for activity?……………………..…Yes No
(If no, please outline unsafe equipment, who may be at risk and action taken, if any.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Clubhouse
Check that there is a first aid kit and that it is easily located / accessible. Check that Kitchen area is clean and free of obvious hazards and that bins are emptied of perishable waste. Check contents of fridge are in date and fresh. Check toilet facilities are clean and stocked with toilet roll, soap, towel and toilet brush/cleaner.
Is the clubhouse in order?………………………………………….………Yes No
(If no, please outline current state and action taken, if any.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Emergency access
Can emergency vehicles access the facilities?……………………………..……Yes No
(If no, please outline the issues and action taken, if any.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Are emergency numbers, the address of the club and warnings about the restricted access (to pass on to emergency services) clearly displayed in the Clubhouse? …………..…Yes No
(If no, please outline the issues and action taken, if any.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Is a working telephone available?………..……………......……………..………Yes No
(If no, please outline the issues and action taken, if any.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Safety information
Is there an approved and checked fire extinguisher available in the kitchen?Yes No
(If no, please outline the issues and action taken, if any.)
______________________________________________________________________________
______________________________________________________________________________
Is there an approved and working smoke alarm(s) in the clubhouse?…………Yes No
(If no, please outline the issues and action taken, if any.)
______________________________________________________________________________
____________________________________________________________________________
______________________________________________________________________________
Are emergency procedures published and accessible to those with responsibility for sessions in the club?………..…………………..………….......…..………….…….…Yes No
(If no, please outline what information is missing and action taken, if any.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Does the club need to take any further action? (If yes, please specify.)
______________________________________________________________________________
Signed: ________________________________ Date:____________________________
