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Welcome to the City of El Paso Fire Department Home Safety Checklist. Fire Prevention Division, Public Education Section (915) 485-5656
Fire >> Home Safety Checklist

Hand Deliver/Fax In Your Application - Download and Fax Form [English] / [Spanish]
Or
Submit Online Below

El Paso Fire Department: 2011 Home Safety Checklist

This checklist will help you understand how safe your home is for you and your family. Also, the information you provide to the El Paso Fire Department (EPFD) is extremely VALUABLE as it will help them to assess our community's home safety. If you have any questions about this checklist, or how to make your home safer, please contact the personnel at your local fire station or Chief Calvin Shanks, Fire Prevention Division, at (915) 485-5656.

Please note that this checklist is completely anonymous; meaning, no names, or addresses can be linked to your response. Therefore, we encourage you to answer the statements honestly and completely. Thank you in advance for taking the time to complete this short checklist today.

INSTRUCTIONS: Depending on the size of your home, we anticipate that this checklist will take approximately 15 - 20 minutes to complete. We recommend to take the following steps: 1) quickly review the checklist without answering the statements; 2) walk through your home and inspect the items in question; and, 3) answer this checklist. Once you are done, please return the completed checklist to your neighborhood fire station or designated drop-off community partner (see the list of community partners on the last page).

Thinking about your home, please check YES, NO, or UNSURE for the following statements (if a statement does not apply to your home, check N/A):

*Required Fields
1. Home Alarms (Select N/A if not applicabale in your home)
Yes No Unsure N/A Statement
a. Home has smoke alarms on every level.
b. Home has a smoke alarm in every bedroom and/or located outside each sleeping area.
c. All smoke alarms are working. (Check using the "test button" to confirm working alarm.)
d. Home has carbon monoxide alarms on every level.
e. Home has carbon monoxide alarms in every bedroom and/or located outside each sleeping area.
f. Carbon monoxide alarms are working. (Check using the "test button" to confirm working alarm.)
 
2. Home Escape and Assistance (Select N/A if not applicabale in your home)
Yes No Unsure N/A Statement
a. Family has a home fire escape plan.
b. The home has occupant/s that require assistance to escape and escape planning requirements in case of a fire emergency have been discussed.
c. Family practices the home fire escape plan at least twice a year.
d. House number is visible from the street.
e. The home is clear of clothes, magazines, newspapers and/or other items that will block your way out in an emergency.
f. Windows used for escape open easily and are not blocked by furniture, security bars, or nailed/painted shut.
g. Security bars, if present, have a functioning quick-release device to allow them to be opened easily.
h. Home has fire sprinkler system.
i. Emergency phone numbers are displayed in a visible location.
j. The family is registered with the City's Emergency Notification program.
 
3. Fire prevention (Select N/A if not applicabale in your home)
Yes No Unsure N/A Statement
a. If there are smokers in your home, they smoke outside the home.
b. If there are smokers in your home, large ashtrays (deep with a heavy base) are provided outside for them.
c. Matches and lighters are stored in a cabinet inaccessible to young children.
d. Burning candles are always attended by a responsible person.
e. Hot water heater is set at 120° Fahrenheit or less. (Check temperature gauge.)
f. Things that can burn are kept at least 3 feet from the water heater and furnace.
g. The furnace is inspected and cleaned annually.
h. Things that can burn are kept at least 3 feet from any portable heating device (i.e., space heaters)
i. Clothes dryer vent pipes are cleaned annually.
 
4. Electrical (Select N/A if not applicabale in your home)
Yes No Unsure N/A Statement
a. Kitchen and bathrooms have functioning GFCI outlets within 6 feet from running water faucets.
b. All receptacle and switch cover plates are installed and not broken or cracked.
c. Receptacles have been tested and are in good working condition — no evidence of shorting, arcing, and/or overheating.
d. Switches are in good condition — no evidence of shorting, arcing, and/or overheating.
e. Flexible cords and cables such as extension cords are not used as permanent wiring (i.e., cords not run through holes in walls, ceiling or floor, run through doorways, windows, under carpets and/or attached to building surfaces).
f. If there are young children (under five years of age) in the home, the home has tamper-resistant outlets.
g. Panel board and distribution equipment (i.e., breaker/fuse box) is accessible for inspection and in good condition — no evidence of overheating, corrosion and/or other damage.
 
5. Kitchen (Select N/A if not applicabale in your home)
Yes No Unsure N/A Statement
a. The stovetop is kept clear of things that can burn (i.e., food containers, paper products, etc.).
b. Small appliances (e.g., blenders, food processors) are unplugged when not in use.
c. When the stovetop is in use, it is never left unattended by a responsible person.
d. The stove is not used to heat the house.
e. There is a portable fire extinguisher in the kitchen.
 
6. Fireplace (Select N/A if not applicabale in your home)
Yes No Unsure N/A Statement
a. Fireplace/s in use have a proper screen and hearth.
b. Things that can burn are kept at least 3 feet from fireplace/s in use.
c. Chimney/s in use are inspected annually and cleaned, if needed.
 
7. Garage (Select N/A if not applicabale in your home)
Yes No Unsure N/A Statement
a. There is a solid door between garage and residence.
b. Gasoline powered equipment is stored in an outside shed or garage, separate from the home.
c. Gasoline is stored in an approved safety container in an outside shed or garage, separate from the home.
 
8. Outside the Home (Select N/A if not applicabale in your home)
Yes No Unsure N/A Statement
a. Outside electrical receptacles are GFCI and they are in good working condition — no evidence of shorting, arcing, and/or overheating.
b. The property is clear of rubbish, trash, brush or tree trimmings accumulation.
c. Barbecue grill is only used outdoors.
d. Swimming pool or hot tub is enclosed by a four sided fence and locked gate
 
PLEASE TELL US A LITTLE MORE ABOUT YOU. By answering the following questions, you will help us understand which areas in El Paso are at most risk. By answering and returning this checklist, your feedback will help El Paso's overall home safety. Please remember that this checklist is completely anonymous.
 
*9. What are the five numbers of your primary residence zip code?  
 
*10. How many people (including yourself) are currently living in your household?
Number of younger children (ages 9 & younger)
Number of older children (ages 10 - 12)
Number of adolescents (ages 13 - 17)
Number of adults (ages 18 - 64)
Number of older adults (ages 65 & over)
 
*11. Do you rent or own your residence?
Rent Own
 
*12. What type of residence do you currently live in?
Single-Family Multiple-Family Apartment
 
*13. What is your highest level of education?
High School or less, no degree High School graduate or GED Some College, no degree
Vocational training Associate's degree Bachelor's degree or higher
 
*14. What languages are primarily spoken in your home?
English Spanish European languages
Asian & Pacific Island languages   Other, please specify:
 
*15. Does anyone living in your home have special needs requiring assistance to escape in event of an emergency?
Yes     No
 
Phone Number (please provide this information if you would like us to contact you):