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Home Fire Safety Survey

Welcome & Thank You for taking this Fire Safety Survery


Please provide your email address if you would like to recieve a copy of your completed survey once submitted

 Exterior Conditions

House exterior is free from hazardous fire conditions
Gas meter has a protective barrier or does not require one
Exterior is clear of excessive rubbish and vegetation that may pose a fire hazard
House number is visible from the street
Is access to your swimming pool / hot tub secured
Propane or gas grill is only used outdoors

Smoke Alarms

Smoke alarms located inside each bedroom
Smoke alarms located outside each bedroom
Smoke alarms located on every level of the home
All smoke alarms located >10 feet from stove
All smoke alarm batteries replaced every six months
All smoke alarms work when tested
All smoke alarms < 10 years old
All smoke alarms tested monthly

Carbon Monoxide Alarms

Carbon monoxide alarm is located on each level of the home
Carbon monoxide alarm batteries replaced at least annually
Carbon monoxide alarm(s) < 7 years old
Carbon monoxide alarms work when tested

Emergency Escape

The occupants have a fire escape plan
Occupants have a designated outside meeting place
All occupants know the outside meeting place
All occupants know the primary and secondary escape routes from the bedrooms
The occupants practice the fire escape plan at least once every 3 months
Bedroom windows used as a secondary escape route open easily
Security bars on windows used as a secondary escape route have a quick release device and it is operational
Exit routes are free from obstructions
Doors do not have double-keyed locks
Emergency escape ladders provided for bedrooms on upper floors


Electrical panel is accessible and in good condition
Circuit breakers are labeled
Outlets and switches have faceplates
Power strips/power bars are used with integral over current protection
Electrical cords do not run under carpet or rugs
Electrical/extension cords are not a tripping hazard
Extension cords are not used as fixed wiring
Kitchen and bathroom outlets are GFCI
Exterior, basement and garage outlets are GFCI
Sufficient airspace left around stereos and TVs
Small appliances unplugged when not in use

Interior Conditions

The home interior is cleared of excessive combustibles
Smoking is not allowed in the home
If smoking is allowed in the home, large ashtrays are provided and emptied each night
Emergency phone numbers are posted in the home
There is a solid core door between the garage and the homes interior
Matches & lighters are secured from children
Lit candles are not left unattended
Flammable liquids are properly stored
A minimum of one functioning flashlight is in the home
Clothes dryer vent duct is made of metal and is cleaned on a regular basis

Heating & Cooking Conditions

Fireplace ashes are properly disposed of outside the home
Fireplace has a proper screen and hearth
A clear 3 feet of space is provided around the fireplace and all space heaters
Liquefied Petroleum (LP) gas heaters with self-contained fuel supplies are not used to heat the interior of the home
The chimney is inspected and cleaned annually
The furnace is inspected and cleaned annually
Hot water discharged in the home is < 120 degrees Fahrenheit

Cooking Conditions

Combustibles removed from the stovetop
Flammable objects, including pot holders, dish towels and curtains are at least 3 feet away from the stove
An adult stays in the kitchen when stove is in use
Pot & pan handles are turned in while cooking

Equipment Installed

Hardwired Smoke Alarm
Battery Smoke Alarm
Carbon Monoxide Alarm
Fire Extinguisher - Please see our online Fire Extinguisher Survey link below

Take the Fire Extinguisher Survey

(Survey will open in a new window)

Personal information contained on this form is collected pursuant to the Municipal Freedom of Information and Protection of Privacy Act, and will be used for the purpose of fire prevention education.  Enquiries regarding the collection of this information may be directed to the Office of the Clerk/Freedom of Information Coordinator, Municipality of Trent Hills, 66 Front Street South, Campbellford, ON K0L 1L0 705-653-1900.

Land Acknowledgement

We recognize the traditional keepers of this land and, specifically our neighbours of the Alderville First Nation, with a formal territorial acknowledgement.

Welcome to the Gunshot Treaty Lands of 1788. It is on these lands and on the shores of the big lake, the Mississauga Anishinabeg met with the Crown to facilitate the opening of these lands for

Let us be reminded of the responsibility we all have in making sure that we respect these lands and waters that give us life and sustain our livelihoods.

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