Fife Independent Disability Network
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Premises:
Type:
Address:
Tel:
1.
Date:
10/06/2005
Parking:
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1.2 On Street
Off Street
Ordinary How Many
1.3 if Off Street How Many Bays: Disable How Many
2.
1.4 Are They An Adequate Size:
Yes
No
1.5 Are The Bays Clearly Marked:
Yes
No
Ground
AVLG331LU111lr : LAIGI Val
2.1 Is It A Level Surface:
Level
2.1 (a) Is There Any Tactile Surfaces:
2.2 Gradient:
Gravel
Yes
No
Level Slight Incline
Moderate incline Severe Incline
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2.4 Steps:
Yes
No
2.5 Ramp:
Yes
No
2.6 Is It A Different Entrance For Wheelchair Users:
Number
Yes
No
Poles
2.7 If Different Is There a Bell To Attract Attention:
2. 7 ka�
T4r A Bell
if
is In V se How Long Dld
2.8 Doors:
Yes
No
I L T alto For Someone T o Attend
Automatic
Manual
Double
Single
Stiff/Heavy
Easy/Light
Door Width:
2.9 Handrails:
3.
Central
Single
Double
None
Yes
No
Yes
No
Accessibility: Internal:
3.1 More Than One Floor/Level:
Size:...
3.2 Lift:
3.3 Button Height:
3.4 Flooring: Is It Level for Wheelchairs and Mobility Problems
3.5 Evac+Chairs Available:
Yes
No
Yes
No
3.6 Provisions for Sensory Impairment:
Sianage: Yes
Adequate Lighting for People with Limited Visibility:
Yes
Hearing:Yes
Induction loop system:Yes
PA system:Yes
3.7 Are Specialised Dogs Welcome:
No
No
No
No
No
Yes
No
Yes
No
3.8 Can The Service Be Brought to the Customer:
N/A
3.9 Are The Corridors Suitable for Wheelchair Users
Yes
No
4. Toilets:
4.1 Available To The Public:
Yes
No
4.2 Ordinary Toilet
Yes
No
4.3 Toilet For Disabled:
Yes
No
4.4 If There Is More Than One Floor Is There A Toilet On Each Floor:
Yes
No
4.5 Size Of Toilet:
4.6 Width Of Door:
4.7 Emergency Pull Cord:
4.8 How Many Grab Rails:
Yes
Drop
Vertical
4.9 Are The Toilets Close To The Venue:
No
Horizontal
Yes
5. In The Event Of A Fire
5.1 Does The Building Have A Fire Alarm:
Yes
No
5.2 Does The Building Have A Visual Fire Alarm:
Yes
No
5.3 Does The Building Have A Smoke Alarm:
Yes
No
5.4 When Did The Fire Brigade Last Check The Building:
Date: ...
5.5 If There Is A Lift Does It Have It's Own Separate Power:
Yes
No
5.6 Is There A Designated Safe Area On Each Floor:
Yes
No
Survey
Item
Detail
I
External
Pavements
Drop Kerbs
Approach
Parking
Y/ N
Location
Door Auto
Y/N
tionDesk HeightScreen
Signage
Height
�
Y/N
ColourBraille
Loop
Y/N
Door Manual
Y/N
Lighting
Entrance
Disabled Spaces
'/kA
Audio
Y/N
Visual
Y/N
Safaty
Areas
Lifts
Stairs
Disabled
Toilet
Staff
I Training
Button Height
Visual Alarm
YIN
Handrail PositionSingleDouble
Central
LockedOpenKey AvailableDoor WidthCubicle Door
Width
sensory impairmentSighted Guide
Awareness
Ramp
Distance to entrance
Opening DirectionHandle HeightDoor Weight
R/L
Information
Fire Alarm
--Surface to
Y/ N
Total Spaces
EntranceSteps/Threshold
Recep
Gradient
1
Type of Company
r i ge Sty,:?et
Company Name
Address
"'e 01592 203786
Fax: 01592 203786
0,1592 6406f 35
Post Code
Contact Name
Position
Audit Date
Auditor / s------------------------------------------