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Fire door inspection checkoff
Fire Door Dojo · Yellow Belt: Inspecting a Fire Door — employer practical training and certification record
The person below completed the online Yellow Belt course. Inspect at least one fire door together, cover Parts 1 and 2, then sign Part 3.
Part 1 — Your site (filled in by the employer)
| Facility name and addressAs it appears on the inspection record (NFPA 80 5.2.2.4) | |
|---|---|
| Door ID and location used for the checkoffDoor number, floor, room or corridor | |
| Door type and fire protection rating, as read from the labele.g. hollow metal single, 90 min | |
| Where inspection records are kept for the AHJPaper or electronic system (NFPA 80 5.2.2, 5.2.2.3) |
Part 2 — Hands-on check (by the supervisor or qualified fire door inspector)
| The employee showed they can | OK | Not yet |
|---|---|---|
| Inspect one swinging fire door from both sides and record all 13 items as pass, fail or N/ANFPA 80 (2013) 5.2.3.5.1, 5.2.3.5.2, 5.2.4.2 | ☐ | ☐ |
| Measure the clearances from the pull side at the top, both edges and the bottom, and state the limits for that doorNFPA 80 (2013) 6.3.1.7, 4.8.4.1 | ☐ | ☐ |
| Operate the door from full open: it closes completely and latches; on a pair with a coordinator, the inactive leaf closes firstNFPA 80 (2013) 5.2.3.5.2(7)–(9) | ☐ | ☐ |
| Identify any hold-open hardware, field modification or sign that breaks the rules, and explain why it failsNFPA 80 (2013) 5.2.3.5.2(10), (11), (13); 4.1.4 | ☐ | ☐ |
| Write one deficiency someone can repair from, and explain the next step: repair without delay, then re-inspectNFPA 80 (2013) 5.2.2.4, 5.2.4.6, 5.2.2.5 | ☐ | ☐ |
Part 3 — Certification
I certify that the person named above inspected a fire door assembly with me against the items in NFPA 80, measured its clearances, and recorded the results correctly.
Keep the signed inspection record with the facility’s fire door records for the AHJ. This form does not replace the employer’s own program, and LifeSafetyWiki does not certify competence. Not an OSHA Outreach (10/30-hour) card.