HEATING AND COOKING
Are you careful not to leave the stove unattended when cooking with Grease, oils, etc?
YES NO
Is your heating equipment checked and cleaned annually by a qualified technician?
YES
NO
Are furnaces, boilers, stoves and smokepipes (chimney connectors) Installed with sufficient
clearance to combustible walls and ceilings and are they in good repair?
YES
NO
Do you have any portable heaters in your home? Are they located in a safe area and properly
maintained?
YES
NO
Do you have a woodburning stove in your home? Is it properly installed with adequate
clearances from floors, walls, ceilings, etc?
YES
NO
Do you make sure there are no curtains, drapes, clothes or furniture near any heater, stove,
fireplace or wood stove in the house?
YES
NO
Do you have the chimney cleaned and checked before each heating season to insure against
chimney fire?
YES
NO
ELECTRICITY
Is the proper size fuse/circuit breaker (15 amps for lighting circuits) provided in each
socket of the fuse/circuit breaker box? Do you use a new fuse - never substitutes - when
replacement is necessary?
YES
NO
Do you make sure circuits are never overloaded?
YES
NO
Are all appliances checked periodically to be certain they are in good operating condition?
YES
NO
Do you make certain that extension cords are never run under rugs, nailed to building surface,
hooked over nails or spliced? Are appliance and other electrical cords in good condition?
YES
NO
Is your TV antenna installed where it cannot fall across power lines? Is it properly secured
or guyed and equipped with a properly grounded lightning arrestor?
YES
NO
PRE-PLANNING FOR FIRE
Have you planned at least two ways to get out of each room in your home? Do you have a
planned meeting place outside?
YES
NO
Have you made - and do you regularly rehearse - exit plans with your family, including the
children?
YES
NO
Do you keep bedroom doors closed at night?
YES
NO
Do you maintain exit ways free and clear of such items as storage, heaters and stoves, where a
fire may start, thus blocking your escape? Are bedroom windows low enough and large enough to
serve as emergency exits?
YES
NO
Do you have your fire department telephone number readily available?
YES
NO
SMOKING HABITS
Do you prohibit smoking in bed in your home? Do you check ashtrays and upholstered furniture
for smoldering cigarette or cigar butts before going to Bed?
YES
NO
Are you careful of how you dispose of cigarettes, cigars and pipe ashes?
YES
NO
Are matches and lighters kept out of the reach of children?
YES
NO
REGARDING THE CHILDREN
Do you make it a rule to never leave small children alone or unattended?
YES
NO
Do you show the babysitter the escape routes from your home and the location of the fire
department telephone number?
YES
NO
Are your children trained to keep a safe distance from flame and spark sources?
YES
NO
Do you and your babysitter know the first rule of fire safety emergencies: Get everyone out
fast and don't go back in.
YES
NO