Foster Home inspection form

• Document No.

• Foster Home Inspection Form

• Client / Site

• Conducted on

  Date

• John Holcomb

• Location
  Address

• Personnel

Owner Information

• Owners Name:

• Address:

• Phone Number:

• Foster Home Agency:

Home Inspection:

• Will there be less than seven children in the Foster Home

  Yes

  No

  N/A

• Are all children ambulatory and capable of self preservation?

  Yes

  No

  N/A

• Is a working smoke detector installed in each sleeping room?

  Yes

  No

  N/A

• Is a working smoke detector installed in the hallway near sleeping rooms?

  Yes

  No

  N/A

• If house is more than one story is a working smoke detector installed at the top of the stairs?

  Yes

  No

  N/A

• Does each sleeping room and living area have at least one of the following secondary means of escape other than the front or back door of the home?<br>A) a door, stairway, passage or hall providing unobstructed travel leading directly to the outside of the dwelling; or<br>B) an outside window with a minimum opening of not less than 5.7 sq. ft. In area , minimum of 20 inches wide, and at least 24 inches high, and higher than 44 inches above the floor, located within 20 ft. of grade accessible to fire department apparatus; or<br>C) a non-locking door into an adjoining room that has a means of escape described in A or B above .

  Yes

  No

  N/A

• Can a person travel from any room of the house to an exit that leads directly outside without having to pass through an interior door that can be locked?

  Yes

  No

  N/A

• Can all primary exterior doors, windows used as secondary means of escape, and any security bars incorporated with these primary and secondary means of escape, be opened from the inside without the use of a key, tool or special knowledge(security code, combination)?

  Yes

  No

  N/A

• Are the closet doors equipped so that a child can open the door from the inside?

  Yes

  No

  N/A

• If the bathroom door is equipped with a lock, can the door be unlocked from the outside during an emergency?

  Yes

  No

  N/A

• Can all bedrooms and/or living areas above the first floor be accessed by a standard set of stairs?

  Yes

  No

  N/A

• Are all gas, wood, or fuel-fired heaters used in the home vented to the outside? (Unless listed and approved)

  Yes

  No

  N/A

• Are gas appliances (heaters, water heaters, stoves) equipped with metal tubing and metal connectors?

  Yes

  No

  N/A

• Are heaters, including wood burning or gas log fireplaces, equipped with immovable screens or barriers to prevent contact with open Flames or hot surfaces?

  Yes

  No

  N/A

• Are all gas-fired heaters inspected annually by a qualified technician?

  Yes

  No

  N/A

• Are combustible items (things that burn) stored away from any stove, heater, or fire place in the Foster Home?

  Yes

  No

  N/A

• Are all lighters and matches kept out of the reach of children?

  Yes

  No

  N/A

• Are flammable liquids stored in safety cans and kept away from heat and children?

  Yes

  No

  N/A

• Is there an operable five-pound dry chemical fire extinguisher available for use in the kitchen?

  Yes

  No

  N/A

• Has a Home Fire Escape Plan written, practiced, and documented?

  Yes

  No

  N/A

• Picture of Home Escape Plan

  Media

• Does the electrical system appear to be in good condition?<br>

  Yes

  No

  N/A

• Comments:

• Signature of Fire Inspector:

  Sign

• Signature of Occupant:

  Sign