CAYUGA - ONONDAGA OFFICE OF SAFETY AND RISK MANAGEMENT PLAYGROUND INSPECTION CHECKLIST

• School District

• Comments:

  Media

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Overall Area

• Is site clear of all dangerous and unsuitable objects? (ASTM 3.3.37, CPSC 4.1)

  Yes

  No

  ITC

  N/A

• Comments

• Add media

  Media

• Is the area free of hygiene hazards? (ASTM 3.1.27, CPSC 4.1)

  Yes

  No

  ITC

  N/A

• Comments

• Are surrounding trees healthy and free form deadwood? (ASTM 1487-17-3.1.27, CPSC 4.1)

  Yes

  No

  ITC

  N/A

• Comments

• Is there an accessbile route? (ASTM 1487-17-3.1.3, 7.1.1 , CPSC 2.2.1)

  Yes

  No

  ITC

  N/A

Surfacing

• Is site free from pounding or surface water? (ASTM 13.2.1, CPSC 4.3)

  Yes

  No

  ITC

  N/A

• Comments

• Type of Surfacing Material

• Depth of Surfacing Material (CPSC 2.4.2.2, ASTM F 2223-13.2.1)

  Safe

  At Risk

  N/A

• Comments

  Media

• Condition of Material (CPSC 2.4.2.2, ASTM F 2223-13.1)

  Good

  Fair

  Poor

  N/A

Condition of Boarder

• Is border material complete (ASTM , CPSC 4.1)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Condition of Border

  Good

  Fair

  Poor

  N/A

• Comments

  Media

PLAY EQUIPMENT

• Are all bolts in place and securely fastened? (ASTM 3.1.27, ASTM 12.1, ASTM 13.1, CPSC 2.5.2, CPSC 5.3.6)

  Yes

  No

  ITC

  N/A

• Comments

• Are all the post foundations firm? (ASTM 10.1.2, CPSC 2.6)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Equipment free of protrusion hazards? (ASTM 3.1.32, ASTM 6.3.2, ASTM 6.4.3, CPSC 3.2 CPSC 3.6)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Are there any pinch hazards? (ASTM 3.1.37, CPSC 3.1, CPSC 3.4)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Is the equipment complete with no missing parts? (ASTM 6.5.1.1, ASTM 8.6.3, ASTM 12.1, CPSC 3.1, CPSC 4.2, CPSC 4.3, CPSC 5.3.8)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Are there any shear hazards? (ASTM 6.5, CPSC 3.1, CPSC 3.4)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Is the equipment free of graffiti? (ASTM 3.1.37, CPSC 4.1)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Is equipment free of any sharp edges? (ASTM 3.1.37, CPSC 3.4)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Are chains in good conditions? (ASTM 3.1.37, CPSC 2.5.1, CPSC 5.3.8, CPSC 5.3.8.1)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Are chain coatings in good condition , free of cracking? (ASTM 5.3.8.1, ASTM 3.1.37 , CPSC 2.4.1)

  Good

  Fair

  Poor

  N/A

• Comments

  Media

• Are connectors (chains, D- clamps, S - hooks etc...) satisfactory? (ASTM 6.4.5, ASTM 6.4.5.1, CPSC 5.3.8, CPSC 5.3.8.1)

  Safe

  At Risk

  N/A

• Comments

  Media

• Swing seats in good condition? (ASTM 3.1.37, CPSC 3.4, CPSC 5.3.8, CPSC 5.3.8.1)

  Good

  Fair

  Poor

  N/A

• Comments

  Media

• Slide discharges have enough impact absorbing material? (ASTM F 2223-13.1, CPSC 2.4.2.2, 5.3.6.4)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Are sliding surfaces undamaged (burning or cracking)? (ASTM 3.1.37 , CPSC 2.5.3)

  Yes

  No

  ITC

  N/A

• Comments

• Are tunnels undamaged and free from obstructions? (ASTM 3.1.37, CPSC 3.4)

  Yes

  No

  ITC

  N/A

• Comments

• Are rotating items moving freely on their bearings? (ASTM 3.1.35, ASTM 9.3.3, CPSC 5.3.3 , CPSC 5.3.4)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Are springs free from cracking or fatigue? (ASTM 8.11, CPSC 5.3.7)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Rope/flexible climbers in good conditions (ASTM 3.1.5 CPSC 5.3.2.3)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Rope, Cables and Chains are attached and anchored at both ends (ASTM 3.1.5, ASTM 6.6.1 CPSC 4.2)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Arch Climbers in on good condition and age appropriate? (ASTM 4.2.1, ASTM 7.3.2.1, CPSC 2.2.3, CPSC 2.5.2, CPSC 5.3.2.2)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Is the Equipment age appropriate? (ASTM 4.2.1, CPSC 2.2.3, CPSC 5.3.2.2, CPSC 5.3.2.)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Track Rides compliant and in good working condition (ASTM 4.2.1, ASTM 8.13, CPSC

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Seesaw Equipment and surrounding material (ASTM 8.10, ASTM 13.1, CPSC 5.3.2.1.4)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Is there the required impact-absorbing material around the fall zones of equipment? (CPSC 2.4.2.2, ASTM F 2223-13.1)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Entanglement hazards. (ASTM , CPSC 3.2, CPSC, 3.2.1 )

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Entrapment Hazards. (ASTM 6.1, CPSC 3.3.1, CPSC B 2.4)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Are the protective coating intact and good condition? (ASTM 4.1.1, CPSC 2.5.1, CPSC 2.5.4)

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Are trees/over growth trimmed back from playground equipment and healthy?

  Yes

  No

  ITC

  N/A

• Comments

  Media

• Signs and Rule posted (ASTM 14.1, CPSC 2.1)

  Media

• Supervision (ASTM, CPSC 2.2.5, CPSC 2.2.7)

  Good

  Fair

  Poor

  N/A

• Comments

  Media

• Additional Comments:

  Media

COMMENTS ( overall ratings)

• Surfacing (impact absorbing material)

  Good

  Fair

  Poor

  N/A

• Graffiti

  Yes

  No

  ITC

  N/A

• Supervision

  Good

  Fair

  Poor

  N/A

• Swings

  Good

  Fair

  Poor

  N/A

• Slides

  Good

  Fair

  Poor

  N/A

• Bolts/caps

  Good

  Fair

  Poor

  N/A

• Climbing Structures

  Good

  Fair

  Poor

  N/A

• Shade structure

  Good

  Fair

  Poor

  N/A

• Playground Rating

  Good

  Fair

  Poor

  N/A

• Jack M. Mekeel

  Sign

• CPSI Number: 54262-425 expires 04/01/2025

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