Backpackers by qingyunliuliu


									              Backpackers, Boarding House & Budget Accommodation Liability Questionnaire

1. Do you have a website?                                           Yes                   No

    If “No”, please attach a brochure or information on the premises and facilities:

2. Fire Alarms:

    Local                   Yes     No                              To brigade            Yes    No

    Back to base            Yes     No                              Does a siren sound?   Yes    No

3. Detectors:

    Thermal                 Yes     No                              Smoke                 Yes    No

    Are they hardwired to monitored alarms?                                               Yes    No

4. Extinguishers

    Dry Chemical            Yes     No                              BCF                   Yes    No

    CO2                     Yes     No                              Water                 Yes    No

    Foam                    Yes     No

    Last Date of Service:

    Maintenance Contract                                                                  Yes    No

    Extinguishers on each floor?                                                          Yes    No

5. Are staff trained in fire fighting?                                                    Yes    No

6. Are all doors and windows fitted with safety strips?                                   Yes    No

7. Are there bars or other impediments on any windows?                                    Yes    No

8. Use of the building:             Backpackers                Boarding House

    Other, please specify

9. Is Operator Licensed?                                                                  Yes    No

10. Are premises licensed / approved?                                                     Yes    No

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    By Whom?

11. Has license ever been cancelled or suspended ?                                     Yes      No

12. Attach a copy of the current fire safety statement plan, floor plan and wiring report (not more than
    4 years old)

13. Do you comply with Council and Fire Regulations?                                   Yes      No

14. What are the trading hours

15. Do you provide accommodation?                                                      Yes      No

16. Number of rooms and beds:

    Number of Rooms                                         Total number of beds

17. Do you have a courtesy bus?                                                        Yes      No


18. Do you have a Restaurant or Bistro? Yes       No


    Do you operate or contract?

19. Do you have playgrounds?                                                           Yes      No


20. Do you organise Tours / recreational Activities?                                   Yes      No

    If “Yes”, please provide details

21. Are there any cooking facilities?                                                  Yes      No

    If “Yes”, are the facilities:                      In accommodation rooms?     Communal Kitchen?

    Other, please specify?

22. Do you have a car park?                                                            Yes       No

    Number of levels:

23. Do you have any other facilities                                                   Yes       No

    Please Specify

24. Does the facility have video surveillance?                                         Yes      No

    Location of cameras

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25. Does the facility record and keep the footage?                                           Yes    No

26. Are staff trained in completion of day book in respect of incident reports?              Yes    No

27. Do you log the following incidents?

    Fights / altercations                                                                    Yes    No

    Complaints                                                                               Yes    No

    Ambulance, Police or Fire                                                                Yes    No

    Injuries                                                                                 Yes    No

    Security or bouncers                                                                     Yes    No

    Employees                                                                                Yes    No

28. What is the age group of the clientele?

    16-20                   %      21-30              %      31-40                %   40+           %

29. Is alcohol allowed in:

    Common Areas                                                                             Yes    No

    Accommodation Rooms                                                                      Yes    No

30. How do you deal with intoxicated people?

31. What is the cleaning policy?

32. Are all the tiles areas non slip?                                                        Yes    No

33. Are all floor surfaces level                                                             Yes    No

    If “No”, please explain:
    Click here to enter text.

34. Is smoking permitted at the facility?                                                    Yes    No

    If “Yes”, in accommodation rooms?                                                        Yes    No

    Designated smoking area?                                                                 Yes    No

    If “Yes”, what Fire Protection is in this area?

35. Do you require that all contractors and sub-contractors hold current liability
    Insurance?                                                                               Yes    No

                                                                                       Limit: $

36. Are there any stairs?                                                                    Yes    No

    If “Yes”, please provide details:

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37. For buildings other than single storey, is there any external fire escape from each storey
    above ground floor?                                                                          Yes    No

38. What is the construction of external fire stairs?

    Steel                          Timber                           Other


39. Are exits on each floor marked with battery backed up illuminated fire exit
    signs?                                                                                       Yes    No
40. Are Emergency Escape procedures posted in:

    (a) All sleeping rooms?                                                                      Yes    No

    (b) In Common Areas?                                                                         Yes    No

41. Are internal Fire Escapes provided?                                                          Yes    No

    If “Yes” do they have self closing fire rated doors?                                         Yes    No

42. Construction of internal Fore Escape Stairwells:

    Double Brick/Block                    Brick Veneer                Timber                 Other

43. Are all areas well lit?                                                                      Yes    No

    If “No”, please provide details:

44. Please provide details of any uninsured losses for the past five (5) years.

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