Business Name:
Name of Applicant:
Position:
Address
Post Code:
Telephone Number(s):
Email address:
M: Are you a member of the Safer
Socialising Partnership (SSP)?:
or; Are you a member of Business Crime Reduction Partnership (BCRP)?
YES
NO
YES
NO
S: How often do you attend meetings
of:
SSP/BCRP Partnerships:
A Local Pubwatch:
Licensed Victuallers Association:
A Trade Association:
All Meetings:
Most Meetings:
Sometimes:
Never:
All Meetings:
Most Meetings:
Sometimes:
Never:
All Meetings:
Most Meetings:
Sometimes:
Never:
All Meetings:
Most Meetings:
Sometimes:
Never:
M: Are you a member of a radio
pager or text pager scheme?
How many handsets do you have?
Who uses the handsets? [You can check more than one box]
YES:
NO:
Number of handsets:
Manager:
Supervisor:
Security staff:
All staff:
Others:
C:
Are
you an accredited Safe Haven?
If
not would you like to become a Safe Haven for victims of crime?
YES
NO
YES
NO
M:
Have you ever completed any of the following?
(You can check more than one box)
M: Please give brief details of
each:
"In-house" Health and Safety risk assessment: YES:
NO:
Police Crime Prevention Survey: YES:
NO:
Any other Risk Assessment: YES:
NO:
M:
What measures do you take to ensure customer safety
in relation to drunkenness?
(Remember it is an offence to permit drunkenness or to sell
alcohol to a person who is drunk on your premises).
Limiting drinks:
Security screening on entry:
Security screening on the premises:
Bar staff decision making:
Sales staff decision making:
Other (please explain below):
S:
Do you actively promote the sale of any of the following?
(You can check more than one box)
Soft drinks:
Tea/Coffee:
Snacks:
Other:
How many staff do you employ?
Total staff:
Managers:
Assistant Managers:
Bar Staff:
Counter Staff:
Other:
M:
How is training provided for your staff?
(You can check more than one box)
In-house:
External Training:
Professional Association Training:
Other:
None provided:
M:
How often is this training provided? (You can check
more than one box)
Weekly:
Monthly:
Quarterly:
Annually:
As needed:
Refresher:
M:
What qualifications are available for staff to achieve?
(You can check more than one box)
BII:
City and Guilds:
Other external examining body:
Trade Association:
Police:
Manufacturers:
M:
What qualifications has the Manager/Designated Premises
Supervisor?
S: When do you provide the following
types of drink container?
If "Certain occasions", please give details:
Toughened bottles: Always:
Certain occasions:
Never:
Plastic bottles: Always:
Certain occasions:
Never:
Glass bottles: Always:
Certain occasions:
Never:
Cans: Always:
Certain occasions:
Never:
Toughened glasses: Always:
Certain occasions:
Never:
C:
Please answer these questions about security
(You can check more than one box)
Please give details of Tape/CD management and storage system:
C Are your premises alarmed?
C Connected to central monitoring
station?
S Do you have a CC TV system?
S If yes, does it record images?
S If yes, does it record sound?
S Is it a digital system?
S Is it a video system?
S Is the system registered for
Data Protection?
M:
Is the transit of cash around your premises discreet,
constantly changed and reviewed?
YES:
NO:
S:
Do you remove cash from fruit machines on a regular
basis?
YES:
NO:
S:
Describe how you reduce the opportunity for criminal
activity by design layout and safety of your premises:
S:
Which of the following measures have you in place
to assist in the prevention of crime and disorder on or around
your premises?
(You can check more than one box)
Chelsea clips:
Roving Security:
Posters/Signs:
Crime Prevention beer mats:
Staff Lockers:
Customer Lockers:
Cloakrooms:
DJ Announcements:
Regular toilet checks:
M:
How do you ensure that all parts of your premises
have sufficient lighting at all times, considering that darkly
lit areas may be attractive to those involved in criminal activities?
(You can check more than one box)
Regular checking:
Specific lighting:
Cordoned off areas:
Other: (Please specify):
M:
Do you have one trained First Aider present during
opening times?
YES:
NO:
M:
What is the renewal date of the first aid certificate?
M:
How do you deal with spillages, which may be hazardous,
to prevent injury to staff and customers?
S:
Do you actively promote anti-drink drive messages
on your premises?
If yes, which methods do you use?
YES:
NO:
Posters:
DJ announcements:
Beer mats:
Bar staff advice:
Counter staff advice:
Other:
No organised method:
M:
How do you ensure your building is in good order to
prevent injury to staff and customers?
(You can check more than one box)
Regular patrols to check fabric of building:
Ongoing maintenance programme:
Instant response to damage:
Regular health and safety checks:
Other:
No organised method:
S:
If any of the following incidents are recorded by
staff, please state where they are recorded?
(You can complete more than one box)
Accidents:
Lost property:
Found property:
Theft:
Banned persons:
Ejected persons:
Fights:
Injuries:
Assaults:
Allegations against staff:
Other incidents:
S: Are your staff trained in
fire routines and evacuation procedures?
S: Do you have an automatic fire
detection system?
C: If yes, is it connected to
a central monitoring station?
YES:
NO:
YES:
NO:
YES:
NO:
S:
How often are fire extinguishers, exits and escape
routes checked?
Daily:
Weekly:
Monthly:
Other:
M:
Who checks these extinguishers, exits and escape routes?
(You can check more than one box)
Manager:
Assistant Manager:
Staff with Responsibility:
Staff Generally:
Other: (please specify):
S:
Where are these practices recorded?
(You can check more than one box)
In Policy Documents:
In Staff handbook:
On Notice Board:
In Staff Circular:
Other: (please specify):
S: Do you communicate with other
licensed premises sharing information about people who give you
concern, e.g. drunks, shoplifters, drug users, large groups etc?
If yes, how do you communicate:
(You can check more than one box).
YES:
NO:
By Telephone:
By Mobile phone:
By Radio:
By Texting:
By Email:
By Fax:
By Meetings:
By Incident Reports:
S:
Do you have a policy in place to manage and reduce
incidents of violence, drunkenness and crime in and around your
premises?
YES:
NO:
M:
If a member of staff finds controlled drugs on your
premises, how do you deal with:
Retention or Disposal?
The person in possession?
Documentation?
S:
How do you review security measures?
You can check more than one box]
Regular assessment:
Annual survey:
Patrols:
Staff suggestions:
Customer suggestions:
Other (please specify):
S:
Which of the following measures have you in place
to assist in the prevention of public nuisance or pollution?
[You can check more than one box]
Litter Bins:
Notices to customers:
Removal or disposal of offensive material:
Report offences or problems to the appropriate authority:
Regular patrols:
Damage/Litter clear ups:
Sound proofing:
Noise limiters:
Shutting windows/doors:
Other (please specify):
S:
Do you have contact with local residents to discuss
issues arising in relation to your premises?
If yes, please describe briefly:
YES:
NO:
S:
How do you ensure that all servicing, waste disposal
and recycling activities occur at a time that is considerate to
local residents?
S:
Please include any other information you feel may
assist in determining your application:
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email the same data to us at:
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