• Inspected by:

  • Date & time


  • Trip hazards

  • Broken glass/litter

  • Poor drainage areas

  • Obstructions of play areas


  • Fencing/backstops

  • Covered play areas/sheds

  • Hardtop play equipment


  • Surface type

  • Surface requires a depth measurement

  • what is depth measurement?

  • Are there any areas in need of surfacing/raking?

Equipment Genereal

  • Smooth surfaces

  • Hardware

  • Entrapments/Angles

  • Capped ends

  • Sharp edges, points, corners, loose welds

  • Protrusions

  • Projections

  • Pinch, crush, or shearing points

  • Tripping hazards

  • Suspended hazards (cables,wires, ropes)

  • Equipment >7' tall

  • Adequate surfacing

Equipment - Specific


  • Smooth surfaces

  • Metal rust, wood rot

  • Head entrapment

  • Loose handholds/rails

  • Loose step/ring/rung

  • Loose nuts/bolts

  • Missing/broken parts

  • Protrusions

  • Adequate lubrication

  • Worn/frayed cables

  • Adequate surfacing

Climbing apparatus

  • Loose nuts/bolts

  • Secure anchor/footing

  • Smooth surfaces

  • Adequate handhold size

  • Adequate surfacing


  • Loose steps or rails

  • Smooth surfaces

  • Loose screws/bolts

  • Broken parts

  • Entanglement hazards

  • Exposed footings

  • Adequate surfacing


  • S-hooks closed

  • Chains/seats/hangers

  • Broken parts

  • Equipment stable

  • Adequate surfacing

  • Any other relevant comments

  • Signature:

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