PLAN TO GET OUT ALIVE |
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YES |
NO |
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- Do you have a home fire escape plan with a pre-determined location to meet outside?
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_______ |
________ |
- Have you practice your plan?
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_______ |
________ |
- Is there at least one smoke alarm on each floor of your home?
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_______ |
________ |
- Do you test your smoke alarm weekly?
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_______ |
________ |
- Is the battery replaced twice a year?
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_______ |
________ |
- Is your smoke alarm less than 10 years old?
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_______ |
________ |
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PLAN TO BE FIRE SAFE |
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- Do you make sure matches and smoking materials are out before disposing of them?
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_______ |
________ |
- Is “No Smoking in your house” a rule in your home?
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_______ |
________ |
- Do you read the warning labels on aerosol cans because some propellants are highly flammable?
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_______ |
________ |
- If you have a family member using oxygen at home, do you prohibit smoking in the same room with the oxygen equipment?
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_______ |
________ |
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ELECTRICAL HAZARDS |
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- Are there enough electrical outlets in every room to avoid the need for multiple attachment plugs and long extension cords?
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_______ |
________ |
- Do you have special circuits for heavy duty appliances, such as air conditioners?
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_______ |
________ |
- Are all extension and appliance cords checked frequently for wear?
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_______ |
________ |
- Do you avoid draping wires and extension cords over pipes, or nails?
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_______ |
________ |
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HOUSEKEEPING HAZARDS |
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- Do you keep your basement, closets and attic cleared of combustible materials
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_______ |
________ |
- If you store paint, varnish, etc., do you keep the metal containers tightly closed?
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_______ |
________ |
- Has everyone in your family been warned never to use gasoline or other flammable fluids for cleaning anything indoors?
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_______ |
________ |
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HEATING AND COOKING HAZARDS |
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- Do you always turn off portable heaters when you go to bed?
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_______ |
________ |
- Do you always refill fuel tank of your portable heaters outdoors?
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_______ |
________ |
- Do you see every portable heater is placed well away (3”) from curtains, bedding, furniture etc.?
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_______ |
________ |
- Is your kitchen range, including the oven and broiler, kept clean of grease?
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_______ |
________ |
- Are curtains near kitchen ranges and heating equipment arranged so that curtains do not blow over or near stove?
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_______ |
________ |
- Does your family’s everyday cooking habit include not leaving food on the stove unattended and keeping hot pot handles turned in from the stove’s edge?
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_______ |
________ |
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SPECIAL FOR PARENTS |
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- Do you keep matches out of reach of children
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_______ |
________ |
- Do you leave a responsible person with your children when you go out, even for a short period of time?
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_______ |
________ |
- When you employ a babysitter, do you instruct them what to do in case of fire or medical emergency?
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_______ |
________ |
- Do you keep candles away from children, combustibles and never leave candles unattended or burning while sleeping?
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_______ |
________ |
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FOR FIRE, MEDICAL,& POLICE EMERGENCY CALL 9-1-1 |
