Information
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Document No.
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Property Name
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Conducted on
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Prepared by
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Location
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Personnel
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Check off each item as it is inspected. Note any problems if they exist and action taken to correct.
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Check area for debris or litter
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Add media
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Missing or full trash receptacles
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Add media
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Damages to equipment - broken / missing components. (Handrails, guard rails, protective barriers, steps, runds, fences, benches and signs)
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Add media
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Protective / Cushioning surface materials
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Add media
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Loose surfacing materials for foreign objects or debris
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Add media
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Loose surfacing materials for compaction and reduced depth, with special attention to heavy use areas such as those under swings and slide exit region
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Add media
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All equipment and other playground features for any hazards which may have emerged
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Add media
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Sharp points, corners and edges - slides, sliding surface of slide chutes for sharp or rough edges caused by deterioration
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Add media
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Protrusions and projections
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Add media
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Missing or damaged protective caps or plugs
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Add media
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Potential clothing entanglement hazards, such as open S-hooks
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Add media
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Pinch, crush and searing points or exposed moving parts
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Add media
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Trip hazards (i.e., exposed footing on anchoring devices and rocks, roots or any other obstacles in the play area
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Add media
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Additional items noted:
