Bed Bug Inspection Checklist

• Building Name

• Address
  Address

• Inspected by

• Conducted on

  Date

Bed Bug Inspection Preventive Measures

Bed Bug Crucial Checkpoints

• Caulk or seal cracks

  Safe

  Needs Improvement

  At Risk

  Not Applicable

• Crevices near beds

  Safe

  Needs Improvement

  At Risk

  Not Applicable

• Bed frames

  Safe

  Needs Improvement

  At Risk

  Not Applicable

• Crevices along baseboards

  Safe

  Needs Improvement

  At Risk

  Not Applicable

• Crevices around pipe chases

  Safe

  Needs Improvement

  At Risk

  Not Applicable

• Crevices around heating and air-conditioning units

  Safe

  Needs Improvement

  At Risk

  Not Applicable

• Holes and other damage in walls

  Safe

  Needs Improvement

  At Risk

  Not Applicable

• Peeling wall paper or chipping paint

  Safe

  Needs Improvement

  At Risk

  Not Applicable

• Chair-rail moldings

  Safe

  Needs Improvement

  At Risk

  Not Applicable

• Loose tiles

  Safe

  Needs Improvement

  At Risk

  Not Applicable

• Hardwood floors

  Safe

  Needs Improvement

  At Risk

  Not Applicable

• Carpets

  Safe

  Needs Improvement

  At Risk

  Not Applicable

• Storage issues

  Safe

  Needs Improvement

  At Risk

  Not Applicable

• Clutter in common areas

  Safe

  Needs Improvement

  At Risk

  Not Applicable

• Other areas that may provide hiding places for bed bugs

  Safe

  Needs Improvement

  At Risk

  Not Applicable

Bed Bug Action Plan

• Does your bed bug action plan include a strategy for responding to reports or complaints?

  Yes

  No

  N/A

• Attach supporting evidence.

  Media

• Respond sympathetically and avoid blame

  Done

  In Progress

  To Do

  Can't Do

• Arrange for a professional inspection

  Done

  In Progress

  To Do

  Can't Do

• Inspect all adjacent apartments (above, below, and on both sides) of the likely infested unit

  Done

  In Progress

  To Do

  Can't Do

• Schedule an intervention for all apartments where bed bugs are found

  Done

  In Progress

  To Do

  Can't Do

• Does your bed bug action plan include a strategy for containing and eliminating infestations?

  Yes

  No

  N/A

• Attach supporting evidence.

  Media

• Educate staff on their role

  Done

  In Progress

  To Do

  Can't Do

• Inspect all adjacent apartments above, below, and on both sides on a regular basis

  Done

  In Progress

  To Do

  Can't Do

• Consider buying or encouraging tenants in adjacent units to buy bed bug resistant mattress covers

  Done

  In Progress

  To Do

  Can't Do

• Encourage tenants in adjacent units to be aware and report signs or symptoms of bed bugs immediately

  Done

  In Progress

  To Do

  Can't Do

• Seal and make repairs to infested and adjacent apartments

  Done

  In Progress

  To Do

  Can't Do

• Does your bed bug action plan include a strategy for disposing infested furniture?

  Yes

  No

  N/A

• Attach supporting evidence.

  Media

• Discourage them from throwing away belongings and/or furniture, OR explain to them how to do so properly

  Done

  In Progress

  To Do

  Can't Do

• Does your bed bug action plan include a strategy for educating and advising tenants?

  Yes

  No

  N/A

• Attach supporting evidence.

  Media

• Give them a bed bug factsheet

  Done

  In Progress

  To Do

  Can't Do

• Explain how to prepare for the pest control company’s inspection

  Done

  In Progress

  To Do

  Can't Do

• Educate tenants on how to prepare for treatment once infestation is confirmed

  Done

  In Progress

  To Do

  Can't Do

• Does your bed bug action plan include a strategy for managing requests for relocation?

  Yes

  No

  N/A

• Attach supporting evidence.

  Media

Completion

• Additional Observations

• Inspector Name and Signature

  Sign