Location

  • Center

  • Room

Previous Inspection

  • Has the last inspection been reviewed?

  • Are there any out standing actions?

Room

  • Carpet Condition

  • Tile Condition

  • Covebase/Baseboard Condition

  • Area Rug Condition

  • Heat/Cooling System Condition - Record Temperature

  • Equipment/Furniture Condition

  • Lighting

  • Emergency Lighting Condition (Flashlight)

  • Condition of Walls

  • Condition of Ceilings/Vents/Air Return

  • Conditions of Door

  • Condition of Fire Extinguisher

  • Condition of Carbon Monoxide Detector

  • Condition of Sink - Record Water Temperture

  • Bubbler/Water Cooler Condition

  • Diapering Table - Record Water Temperature

  • Condition of Windows

  • Condition of Blinds / Shades

  • Condition of Storage Units

  • Condition of Exit Signs

  • Locked Cabinet

  • Outlet Cover Condition

Bathroom

  • Tile Condition

  • Covebase/Baseboard Condition

  • Condition of Walls

  • Lighting

  • Condition of Ceilings/Vents/Air Return

  • Conditions of Door

  • Condition of Sink - Record Water Temperture

  • Condition of Toilet/Urinal

  • Bathroom Daily Check List Updated?

Sign Off

  • Maintenance Tech Signture

  • Inspector Signature

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