Information
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Document No.
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Audit Title
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Site
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Location
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Conducted on
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Prepared by
General
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Visibility for Supervision (min 2m)
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Softfall (Synthetic Material)
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Comment (Check for degradation of surface or chewing gum, foreign objects, rocks, burns, Joints, wear layer, impact attenuation layer or sub- base failure)
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Edging
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Loose-fill Material<br>1. Check depth min 300-400 mm, top up or rack as required<br>2. Material deterioration or contamination
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Accessibility<br>1. Check Access ramps, pathways entrances free of slipping and tripping hazards<br>2. Paths around playground clear of hazards, cracks, trips, vegetation<br>3. Gates, closing & locking devices operational, no finger entrapment (>12)<br>4. Access, entrance & ancillary items free of protrusions/ sharp edges
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Vegetation<br>Check litter, glass, syringes, eye hazards etc
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Sandpits<br>1. No ponding water, drainage issues or health hazards.<br>2. Sandpit edges and supports intact & secure.<br>3. Sand raked to remove foreign objects, fouling, glass.
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Playground Surface<br>1. Pay particular attention to surfacing subject to high use, beneath high equipment, forced movement devices and exposed footings<br>2. Rubbish that may be hygiene issue, broken glass, rocks, foreign objects likely to cause injury removed<br>3. Drainage operational, no contamination from run off
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Equipment - Platforms, Structures and Frames<br>1. Foundation, corrosion and free of movement<br>2. Water penetration, physical damage<br>3. Guards, rails, screws and bolts are present and secure<br>4. No loose items, and equipment is free from moss, mould, unhygienic material
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Chains, Ropes, Cables, Net and Tires<br>1. No damage, frays, worn or cut wire strands.<br>2. No entrapment hazards, no corrosion or sharp edges.
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Bubbles and water features (Clean and operationational)
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Is graffiti present?
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
Play Equipment
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Basketball Ring
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Rockers
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Sea Saws
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Swings<br>1. Check for squeaks, swing action, quietness.<br>2. Wear and tear of seat, chains and connectors. <br>3. Seat clearance from ground >350mm (tire swing > 400mm)
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Swing type (Select all that apply)
- Single
- Double
- Multipe
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Carousel (Rotating Equipment)
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Speed limited to 5 meters per second?
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Bearing functionality confirmed?
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Comment (Check for covers, seats, pedals, rope secure, no entrapment , protrusions or sharps including underside)
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
Climbing equipment
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Fortress / tower
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Slide<br>1. No damage or foreign objects on slide bed/sides, wear and tear, entrapment or protrusions<br>2. Structure, slides & supports-stability, looseness, corrosion, splinters.<br>3. Runout section fall height <350mm(or <200mm small slides)
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Net / spiderweb
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Flying fox<br>1. Check trolley operation and cable is secure<br>2. No missing parts, and are free from rot and corrosions
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Speed limited to 7 meters per second
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
Exercise equipment
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Sit up bench
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Chin dip lift
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Hip twist
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Air walk
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Hip swing
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Sit up (laying) or push up
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Leg up
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
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Aerobic step ups
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
Additional Items
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Additional Items
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Comment
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Outcome (inc CRM no, if needed)
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CRM Required
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Add to Winter List
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Date completed
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Photo
Office Use
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Signature required
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COORDINATOR COMMENTS
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Coordinator signature required
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Date required
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Data entry completed - CRM created or job added to Winter list Docs #3111629
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CRM No. and Date completed