Title Page

  • Building Name

  • Conducted on

  • Prepared by

  • Location

Stairs/ Floors/ Laundry

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  • Instructions:
    1. Answer "Yes", "No", "N/A" for the questions below.
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  • Stairs maintained, inspected, and repaired if defective

  • Stairs free of trip hazards

  • Stair treads, including front edges, have non-slip/slip resistant surfaces

  • Worn or broken treads repaired promptly

  • All stairs have firm railings and good lighting

  • Stairs kept clear of obstructions

  • The stairs are in safe condition

  • Stairs are provided where there is a change in structure level

  • Fixed stairs are at least 22 inches wide

  • All stairs have railings on all open sides of the Stairways and stair platforms

  • Stair railings are provided on at least one side of a closed stairway

  • Every flight of stairs four (4) or more risers high has standard hand rails

  • Stairways less than 44 inches wide with both sides enclosed, have railing on the right side descending, as a minimum

  • Stairways less than 44 inches wide with one open side have at least one railing on the open side

  • Stairways less than 44 inches wide with both sides open have railings on both sides

  • Stairways between 44 and 88 inches wide have railings on both sides

  • Stairways more than 88 inches wide have railings on both sides and one in the middle

  • Lighting is adequate (including emergency lighting)

  • Ramps have non-slip surfaces

  • Stair treading is in good condition

  • Stairways are kept clear and are not used for storage

  • Handrails are in good condition

  • Guardrails are installed (where needed)

  • Corridors are kept clear of equipment and supplies

  • No storage is allowed within 18 inches of sprinkler heads (24 inches of ceiling where no sprinkler system exists)

  • Appropriate ladders are provided for high storage area access

Floors and Open Floors

  • Every open-sided floor or platform 4 feet or more above an adjacent floor level or ground level is guarded by a standard railing on all open sides

  • The following are protected by either standard guard rails or other methods (i.e. covers, gates, etc.): stairway floor openings, ladder way floor openings, hatchway and chute openings, skylight pit and trapdoor openings, and manhole floor openings

  • The top surface of the railing is 42 inches (nominal) from upper surface of top rail to floor, platform, runway, or ramp level

  • The top rail is smooth-surfaced throughout the length of the railing

  • The intermediate rail is approximately halfway between the top rail and the floor, platform, runway, or ramp

  • Every flight of stairs having four or more risers is equipped with standard stair railings or standard hand rails

  • The railing is able to support 200 lbs. in any direction, at any point on the top rail

  • The railings and supports are securely fastened

  • All railings, covers, grates, screens, etc. are capable of withstanding 200 lbs. of force applied in any direction except upward


  • Work spaces are properly ventilated and illuminated

  • Spaces are neat, clean, and free of clutter

  • Equipment, belts, gears, and steam lines are guarded to prevent accidents

  • Dryer lint traps are cleaned on a regular basis

  • Fire regulations are prominently displayed and enforced

  • Dryer vents are connected to metal exhaust ducting where they terminate to the exterior

  • Emergency shutoff valves and switches are conspicuous and easily operated

  • Please proceed to the next section for Part 2.

Lighting/ Ramps/ Housekeeping/ Playground


  • General lighting in all unit locations are adequate

Ramps and Loading Docks

  • Ramps have limited slope and nonskid surfaces

  • Changes in floor level clearly marked

  • Loading docks have metal plates and drainage

Outside Good Housekeeping

  • Loose/missing tiles, broken concrete and turned-up rugs fixed immediately

  • All indoor and outdoor walkways have adequate lighting

  • Lights kept clean and burned-out bulbs replaced promptly

  • All holes in the side walks covered

  • Walkways kept clear of obstacles

  • Trash disposed of promptly and properly

  • All drop offs marked and protected

  • Construction and cleaning areas blocked off and clearly marked

  • Icy areas sanded promptly

  • All spills cleaned up immediately

Playground Equipment

  • Playgrounds are inspected regularly to ensure that equipment and surfacing are in good condition

  • Surfaces around playground equipment are covered with an appropriate level of acceptable material (e.g., wood chips, sand, pea gravel, mats made of safety-tested rubber or rubber-like materials) for the height of equipment present

  • Protective surfacing extends at least 6 feet in all directions from play equipment. For swings, surfacing extends, in back and front, twice the height of the suspending bar (except for tot swings)

  • Surfacing material is maintained (prevent compaction or displacement) at appropriate depths throughout the play area

  • Sharp points, edges, and corners, protrusions, suspension hazards, and head or finger traps are eliminated

  • Dangerous hardware, like open "S" hooks or protruding bolt ends are eliminated

  • Spaces that could trap children, such as openings in guardrails or between ladder rungs, measure less than 3.5 inches or more than 9 inches

  • Elevated surfaces, such as platforms and ramps, are provided with guardrails to prevent falls

  • Tripping hazards, such as exposed concrete footings, tree stumps, and rocks are eliminated (footings should be under the protective surfacing material)

  • Lightweight plastic or rubber swing seats are used in place of wood or metal seats (to reduce severity of impact injuries)

  • Deteriorated paint (peeling, cracking, chipping, or chalking) on playground equipment is evaluated and tested (if necessary) for lead content and appropriate action(s) taken

  • Fiber ropes are not utilized to suspend swings (unraveled fiber ropes have resulted in strangulation incidents)

  • All playground equipment is well maintained

  • Supervision of children on playgrounds occurs where appropriate (e.g., Child Day Care Centers) to ensure their safety

  • The play area has satisfactory drainage, especially under swings and slide discharge areas

  • Play structures which are more than 30 inches high are spaced at least 9 feet apart

  • The average incline angle of slides is not greater than 30 degrees (no single portion of the slide chute exceeds 50 degrees)

  • Please proceed to the next section for Part 3.

Outside Area/ Swimming Pools

Outside Areas

  • All vehicle travel areas and parking areas free from hazards

  • All ponds have adequate protection from children falling into them

  • The pool have proper signs

  • The pool have proper life saving equipment

  • The pool area free from obvious hazards

  • All pool chemicals and facility maintenance chemicals properly stored in a locked area

  • All fire extinguisher checked monthly by maintenance and semi-annually by the fire extinguisher service company

  • All resident entry areas free from obstructions where intruders could hide

  • The outside playground area been checked and all playground equipment checked for unprotected sharp edges, missing covers on bolts and broken pieces

  • Any sprinklers causing wet areas on sidewalks that could cause the growth of algae and pose a slipping hazard

  • Maintenance have a card they leave in a resident’s apartment to let them know they were in their apartment when the resident was not home

  • All repairs to any stair, handrail, landing rails, sidewalk, and raised walking surfaces been made and documented

  • Aisles are established and are kept clear (minimum 36")

  • No tripping hazards present

  • Floors are even (no holes or cracks)

  • Carpets, rugs, and mats do not present a tripping hazard

  • Floors are kept dry as practical

  • Entrance mats are available for wet weather

  • Outside walkways and stairs are in good repair

Swimming Pools

  • Pools are constructed of materials which are nontoxic, impervious and enduring, and watertight with a smooth and easily cleaned surface

  • Stairs, ladders, or recessed steps are provided at both the shallow and deep ends of the pool

  • Stairs, ladders, and recessed steps are located so they do not interfere with racing lanes

  • The finished texture of walks are non-slip and cause no discomfort to bare feet

  • Water depths are plainly marked at or above the surface on the pool wall, or on the edge of the deck or walk next to the pool

  • Depth markings are in numerals of 4 inch minimum height, of a color contrasting with background, and are provided on both sides and ends of pool

  • Electrical wiring for power and lighting associated with the pool conforms to Article No. 680 of the National Electric Code

  • All portions of the potable water supply system that serve the swimming pool and auxiliary facilities are protected against backflow

  • All potable water introduced (directly or through a recirculation system) is supplied through an air gap

  • Recirculation and filtration equipment is of adequate size to turnover the entire pool water capacity at least three (3) times every twenty-four (24) Hour period

  • Disinfecting residuals in the pool water are equivalent to 0.6 to 1.0 ppm of free available chlorine (FAC)

  • Monthly pool bacteriological tests are conducted, daily chlorine residual samples are taken, and results logged and available

  • Chlorinating procedures for the pool maintain minimum acceptable free available chlorine residuals based on pH and other factors

  • Free available chlorine readings are obtained every 2 hours during pool use at varying locations with one test made at peak occupant load

  • A life line is provided two feet toward the shallow portion from the break in grade between shallow and deep portions, with its position marked with colored floats at not greater than 5 feet

  • Calcium hypochlorite compound is not stored or subject to spillage, moist or wet environment, or with oxidizing material

  • Adequate dressing and sanitary plumbing facilities are provided for pool patrons

  • Drinking fountains are provided at the pool and in the bathhouse

  • Metal or plastic soap dispensers are provided at each lavatory and between each pair of shower heads

  • Patrons are required to take showers before entering the pool

  • Swimming pool inspections are conducted at least monthly by a Maintenance Department representative

  • Both a Coast Guard approved ring buoy with an attached 1/4" rope (minimum length = 1 ½ width of pool) and a life pole or shepherd's crook with minimum length handle of 12' is provided for every 2,000 sq. ft. of pool area

  • Outdoor swimming pools are protected by a 4' high (minimum) barrier with self-closing, positively latching door/gate capable of being locked

  • A telephone is provided in the immediate deck area for possible emergency needs

  • Glass containers are prohibited in the pool area and food and beverage consumption is prohibited on the pool walks

  • Pool managers are qualified in pool and filter operation and principles and practices of sanitation

  • The pool is supervised by a person with a Red Cross or equivalent certifications in life saving, first aid, filter operation, and sanitation

  • Sanitary facilities (e.g., showers, lavatories) are provided for use by hot tub patrons

  • Please proceed to the next section for Part 4.

Electrical/ Fire/ Emergency

Electrical Hazards

  • Extension cords are not used as permanent wiring and/or are unplugged from wall outlet when not in use

  • When used, all extension cords are 3-wire type and in good condition - no splices or broken insulation are allowed

  • If used, multi-outlet power strips are UL listed and have circuit breakers

  • Extension cords and power strips are plugged directly into wall outlet, not other extension cords or power strips

  • Equipment power cords are in good condition with no splices or broken insulation

  • Plugs are in good condition - there are no exposed wires and the ground is not removed from 3-way plugs

  • All wall outlet and junction box covers are in place

  • Electric circuit panels are kept clear (at least 36 inches open area)

  • Electrical circuits are not overloaded

  • Wires or extension cords do not run under carpets or rugs, through doorways, or placed in other traffic areas

Fire Prevention, Emergency Exits, Housekeeping

  • Fire extinguishers are not obstructed

  • Fire doors are not blocked open

  • Exits are unobstructed and kept unlocked during normal business hours or special events

  • Exits properly marked, exit signs illuminated

  • Good housekeeping is practiced - liquid spills are absorbed, (especially oils), and excess paper and trash is removed

  • Flammable/Combustible liquids are stored properly

  • Electric space heaters are UL listed with working temperature controls and tip switches

  • There are no holes through walls or ceilings, and all ceiling tiles are in place

  • Occupancy limits are observed

  • Inspected by:

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