• Approval No.

  • Business Name

  • Business Address
  • Postal Address

  • Contact Name

  • Contact Number

  • Conducted on

  • Prepared by

  • Email Address


  • Caretaker/Resident manager on site?

  • Guest Register maintained?<br>-Names and addresses<br>-an identifying number for accommodation or a site<br>-If Caravan - registration number of the caravan an if applicable the vehicle towing it<br>-Date when hiring of the accommodation or site begins and ends

  • Directions

  • Timeframe for Compliance

  • Total number of guests that can be accommodated at the park

  • Is it readily available for emergency services?

  • Copy of current site plan?

  • Are suitable pest control measures in place?

Caravan park information

  • Number is sites (total)

  • Number of caravan sites

  • Number of camping sites (tent sites only)

  • Number of sites with ensuites

  • Number of Cabins

  • Number of cabins with ensuites


  • Are the cabins onsite maintained in a clean and tidy condition?

  • Directions

  • Timeframe for Compliance

  • Maintenance issues?

  • Directions

  • Timeframes for Compliance

  • Pest control measures in place?

  • Directions

  • Timeframe for Compliance

  • Is the privacy assured? Is the premises secure?

  • Directions

  • Timeframe for Compliance

Land and site requirements

  • Adequate Lighting? (AS4282-1997) - Are the roads adequately lit between sunset and sunrise?

  • Directions

  • Timeframe for Compliance

  • Numbering of sites?

  • Directions

  • Timeframe for Compliance

  • Distance between sites?


  • Entry and Exit road

  • Road surface maintained?

  • Directions

  • Timeframe for Compliance

  • Speed Limit signs?

  • Directions

  • Timeframes for Compliance

  • Add media

Utility Services

  • Is the park connected to a town water

  • 1 water connection per dwelling 1per 4 camp sites

  • Caravan park must be connected to the mains sewer

  • Short term and camp site must have 1 sewer and 1 grey water dump point

  • All sites within the park must be adequately drained

  • Long term site must provided with electricity connected to its own circuit and meter

Shower and toilet facilities

  • Toilet shower and laundry amenities located within 100m of caravan, tent or cabin sites; and not closer than 6m to any caravan, tent or cabin site?

  • Toilet and shower block kept in a clean and healthy condition

  • Hot/cold water to every shower, bath and hand wash basin?

Male Toilets

  • Number of Male toilets

  • Length of the Urinals in meterage

  • Number of hand basins male

  • Soap and paper towel/air dryer provided?

  • Number of male showers

  • Privacy assured in both showers and toilets

Female Toilets

  • Number of female toilets

  • Number female basins

  • Soap and paper towel/air dryer provided?

  • Number of female showers

  • Privacy assured in both showers and toilets?

Unisex Toilets

  • Disable Facilities

  • Hand wash basin provided?

  • Soap and paper towel/air dryer provided?

  • Privacy assured?

Laundry facilities

  • Number of washing machines

  • Number of dryers

  • Meterage of clothes line OR number of clothes hoist provided?

  • Number of laundry tubs

  • Washing machines and laundry tubs are connected to hot and cold water

  • Number of irons

  • Number of ironing boards

  • Construction of the laundry buildings comply with the local government regulations

  • Laundry facilities maintained in a clean and healthy condition

General compliance with Local Government Regulations

  • Garbage is stored in sealed containers and disposed of weekly

  • Fire hydrants max distance of 90m form any part of the park

  • Fire reels are easily accessed

  • Car wash bay is provided


  • Signature of EHO

  • Signature of caravan park owner/ manager or person interviewed

  • Date

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.