CDP./ H. Y .S Dorm/Administration Inspection

• Conducted on

  Date

• Person or persons completing the safety inspection

  Select Safety Safety and Security Manager

  • Safety
  • Safety and Security Manager

• Centers are required to conduct and document weekly/monthly inspections. Results of the inspection are recorded below. In the event a deficiency is identified but cannot be corrected, the Safety Officer will submit a maintenance work order. Completed checklist must be returned to the Center Safety Officer, based on center policy. The general safety and health checklist applies and should be attached to the checklist.

• Area of Inspection

  Select Administration Dorm

  • Administration
  • Dorm

• Inspection completed by?

  Safety

  Safety and Security Manager

• Date and Time of inspection

  Date

General Requirements

• All students doors or any door leading to an egress corridor must positive latch on its own. No door can be held open by any device that will not release the door when the fire alarm is activated.

  Yes

  No

  N/A

• All entrance/exit doors to egress corridors are fully operational and bear then appropriate for rating. Frame and door have a fire rating tag. Doors are free from holes and breakage.

  Yes

  No

  N/A

• All fire egress maps include;<br>(A) Primary and secondary escape routes.<br>(B) You are here marking<br>(C) Location of alarm pull stations and fire extinguishers <br>

  Yes

  No

  N/A

• All panic bars are in good working condition ad operational.

  Yes

  No

  N/A

• CO2 detectors are present, properly located, and operational.

  Yes

  No

  N/A

• All exit lights are in good condition, operational, and indicate the proper direction of egress.

  Yes

  No

  N/A

• All emergency lighting is in good condition and operational.

  Yes

  No

  N/A

• All ceiling tile are in place and there are no holes or gaps in excess of 1/8th".

  Yes

  No

  N/A

• All electrical panels are labeled appropriately.

  Yes

  No

  N/A

• All electrical panels have a 3 foot entry way to panel. Panel doors close and lock.

  Yes

  No

  N/A

• All G.F.C.I. receptacles are operational.

  Yes

  No

  N/A

• Electrical panel knockouts are in place.

  Yes

  No

  N/A

• Permanent electrical circuits are utilized rather than extension cords.

  Yes

  No

  N/A

• Area is free of missing tiles both floor and wall.

  Yes

  No

  N/A

• Materials are safely stacked and not within 18" vertically or 36" horizontally of a sprinkler head.

  Yes

  No

  N/A

• Light fixtures are free of missing lens covers.

  Yes

  No

  N/A

• Walking surfaces are free of slip/trip hazards such as flooring tears, bumps, carpet sags, or other trip hazards.

  Yes

  No

  N/A

• Walking surfaces are free of spilled liquids or water.

  Yes

  No

  N/A

• Sidewalks and other walking surfaces are free of cracks in excess of 1/4".

  Yes

  No

  N/A

• All exterior lighting is operational.

  Yes

  No

  N/A

• Cleaning materials and chemicals are properly stored, not in student's rooms, or left unattended. Chemical containers are properly labeled.

  Yes

  No

  N/A

• All janitorial closets and mechanical rooms are closed and locked.

  Yes

  No

  N/A

• All flammable or hazardous chemicals are properly stored when not in use. Flammable storage cabinets are closed at all times.

  Yes

  No

  N/A

• M. S. D. S. /S. D. S. information is openly available to all staff and students.

  Yes

  No

  N/A

• Flammable storage cabinets are properly vented to the outside and have proper signage.

  Yes

  No

  N/A

• Grinders or other power tools have the appropriate guarding and are in proper working condition.

  Yes

  No

  N/A

• Area is free of evidence of vermin.

  Yes

  No

  N/A

• Staff and students are utilizing proper footwear (steel toe or slip resistant closed toe).

  Yes

  No

  N/A

• Dryer vents are clean and properly attached.

  Yes

  No

  N/A

• Signature of inspector

  Sign

• Center Director

  Sign

• Safety Committee Member

  Sign

• Safety Committee Member

  Sign

• Safety Committee Member

  Sign

• Safety Committee Member

  Sign

• Safety Committee Member

  Sign

• Safety Committee Member

  Sign

• Safety Committee Member

  Sign