GENERAL SAM TEMPLATE FOR INSPECTION

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Front door

• Is the door in good condition?

  Yes

  No

  N/A

• Is the lock in good working order?

  Yes

  No

  N/A

• Is there a security chain?

  Yes

  No

  N/A

• Is there a peep hole?

  Yes

  No

  N/A

Foyer

• Are the front entrance closets in good condition?

  Yes

  No

  N/A

• Do the front entrance closet doors work properly?

  Yes

  No

  N/A

• Is the storage room in good condition?

  Yes

  No

  N/A

• Is the flooring in good condition?

  Yes

  No

  N/A

• Are the baseboards all attached and in good condition?

  Yes

  No

  N/A

• Is the light fixture in good condition?

  Yes

  No

  N/A

• Are the light switch and cover secure and in good condition?

  Yes

  No

  N/A

Kitchen

• Is the fridge clean and in good working order?

  Yes

  No

  N/A

• Enter the fridge model number.

• Is the stove clean and in good working order?

  Yes

  No

  N/A

• Enter the model number for the stove.

• Is the dishwasher clean and in good working condition?

  Yes

  No

  N/A

• Enter the dishwasher model number.

• Are the upper cupboards all secure and in good condition?

  Yes

  No

  N/A

• Is the countertop secure and in good condition?

  Yes

  No

  N/A

• Are the lower cabinets all secure and in good condition?

  Yes

  No

  N/A

• Is the breadboard in good working order?

  Yes

  No

  N/A

• Is the sink clean and leak free?

  Yes

  No

  N/A

• Are the faucets clean and leak free?

  Yes

  No

  N/A

• Is the drain properly sealed and does it have the plug?

  Yes

  No

  N/A

• Is the kitchen window and screen in good condition?

  Yes

  No

  N/A

• Is the breaker panel in good working order?

  Yes

  No

  N/A

• Is the exhaust fan clean and in good working order?

  Yes

  No

  N/A

• Are the walls and ceilings in good condition?

  Yes

  No

  N/A

• Is the flooring in good condition?

  Yes

  No

  N/A

• Are all the baseboards secure and in good condition?

  Yes

  No

  N/A

• Is the light fixture in good condition?

  Yes

  No

  N/A

• Are the light switch and cover secure and in good condition?

  Yes

  No

  N/A

• Are the wall outlets secure and in good condition?

  Yes

  No

  N/A

Dining room

• Is the window and screen in good condition?

  Yes

  No

  N/A

• Are all the baseboards secure and in good condition?

  Yes

  No

  N/A

• Are the baseboard heaters secure and in good working order?

  Yes

  No

  N/A

• Are the walls and ceilings in good condition?

  Yes

  No

  N/A

• Is the flooring in good condition?

  Yes

  No

  N/A

• Is the light fixture in good condition?

  Yes

  No

  N/A

• Are the light switch and cover secure and in good condition?

  Yes

  No

  N/A

• Are the wall outlets and covers secure and in good condition?

  Yes

  No

  N/A

Living room

• Are the windows and screens in good condition?

  Yes

  No

  N/A

• Are all the baseboards secure and in good condition?

  Yes

  No

  N/A

• Are the baseboard heaters secure and in good working order?

  Yes

  No

  N/A

• Are the walls and ceilings in good condition?

  Yes

  No

  N/A

• Is the flooring in good condition?

  Yes

  No

  N/A

• Is the light fixture in good condition?

  Yes

  No

  N/A

• Are the light switch and cover secure and in good condition?

  Yes

  No

  N/A

• Are the wall outlets secure and in good condition?

  Yes

  No

  N/A

• Is the patio door and screen in good condition?

  Yes

  No

  N/A

• Is the balcony floor and railings in good condition?

  Yes

  No

  N/A

• Is the air conditioner in good condition?

  Yes

  No

  N/A

• Are the curtain tracks secure?

  Yes

  No

  N/A

• Are the curtains clean and in good condition?

  Yes

  No

  N/A

• Is the thermostat secure and in working order?

  Yes

  No

  N/A

• Is the tv cable in good condition?

  Yes

  No

  N/A

Hallway and stairs

• Are the windows and screens in good condition?

  Yes

  No

  N/A

• Are all the baseboards secure and in good condition?

  Yes

  No

  N/A

• Are the baseboard heaters secure and in good working order?

  Yes

  No

  N/A

• Are the walls and ceilings in good condition?

  Yes

  No

  N/A

• Is the flooring in good condition?

  Yes

  No

  N/A

• Is the light fixture in good condition?

  Yes

  No

  N/A

• Are the light switch and cover secure and in good condition?

  Yes

  No

  N/A

• Are the wall outlets secure and in good condition?

  Yes

  No

  N/A

• Is the smoke detector in good order?

  Yes

  No

  N/A

• Is the smoke detector battery current?

  Yes

  No

  N/A

• Are the closet doors and shelving inside secure and in good condition?

  Yes

  No

  N/A

• Are the stairway handrails secure and in good condition?

  Yes

  No

  N/A

Master bedroom

• Is the door to the bedroom in good condition and secure?

  Yes

  No

  N/A

• Are the windows and screens in good condition?

  Yes

  No

  N/A

• Are all the baseboards secure and in good condition?

  Yes

  No

  N/A

• Are the baseboard heaters secure and in good working order?

  Yes

  No

  N/A

• Are the walls and ceilings in good condition?

  Yes

  No

  N/A

• Is the flooring in good condition?

  Yes

  No

  N/A

• Is the light fixture in good condition?

  Yes

  No

  N/A

• Are the light switch and cover secure and in good condition?

  Yes

  No

  N/A

• Are all the wall outlets secure and in good condition?

  Yes

  No

  N/A

• Are the curtain tracks secure?

  Yes

  No

  N/A

• Are the curtains clean and in good condition?

  Yes

  No

  N/A

• Is the thermostat secure and in good working order?

  Yes

  No

  N/A

• Are the closet doors and shelving inside secure and in good condition?

  Yes

  No

  N/A

Second bedroom or den

• Is the door to the bedroom in good condition and secure?

  Yes

  No

  N/A

• Are the windows and screens in good condition?

  Yes

  No

  N/A

• Are all the baseboards secure and in good condition?

  Yes

  No

  N/A

• Are the baseboard heaters secure and in good working order?

  Yes

  No

  N/A

• Are the walls and ceilings in good condition?

  Yes

  No

  N/A

• Is the flooring in good condition?

  Yes

  No

  N/A

• Is the light fixture in good condition?

  Yes

  No

  N/A

• Are the light switch and cover secure and in good condition?

  Yes

  No

  N/A

• Are the wall outlets secure and in good condition?

  Yes

  No

  N/A

• Are the curtain tracks secure?

  Yes

  No

  N/A

• Are the curtains clean and in good condition?

  Yes

  No

  N/A

• Is the thermostat secure and in good working order?

  Yes

  No

  N/A

• Are the closet doors and shelving inside secure and in good condition?

  Yes

  No

  N/A

Third bedroom

• Is the door to the bedroom in good condition and secure?

  Yes

  No

  N/A

• Are the windows and screens in good condition?

  Yes

  No

  N/A

• Are all the baseboards secure and in good condition?

  Yes

  No

  N/A

• Are the baseboard heaters secure and in good working order?

  Yes

  No

  N/A

• Are the walls and ceilings in good condition?

  Yes

  No

  N/A

• Is the flooring in good condition?

  Yes

  No

  N/A

• Is the light fixture in good condition?

  Yes

  No

  N/A

• Ae the light switch and cover secure and in good condition?

  Yes

  No

  N/A

• Ae the wall outlets secure and in good condition?

  Yes

  No

  N/A

• Are the curtain tracks secure?

  Yes

  No

  N/A

• Are the curtains clean and in good condition?

  Yes

  No

  N/A

• Is the thermostat secure and in good working order?

  Yes

  No

  N/A

• Are the closet doors and shelving inside secure and in good condition?

  Yes

  No

  N/A

Bathroom

• Is the door to the bathroom in good condition and secure?

  Yes

  No

  N/A

• Are the windows and screens in good condition?

  Yes

  No

  N/A

• Are all the baseboards secure and in good condition?

  Yes

  No

  N/A

• Are the baseboard heaters secure and in good working order?

  Yes

  No

  N/A

• Are the walls and ceilings in good condition?

  Yes

  No

  N/A

• Is the flooring in good condition?

  Yes

  No

  N/A

• Is the light fixture in good condition?

  Yes

  No

  N/A

• Is the light switch and cover secure and in good condition?

  Yes

  No

  N/A

• Is the razor outlet and cover secure and in good condition?

  Yes

  No

  N/A

• Is the exhaust fan or vent clean and in good working order?

  Yes

  No

  N/A

• Are the closet doors and shelving inside secure and in good condition?

  Yes

  No

  N/A

• Is the basin clean and in good condition?

  Yes

  No

  N/A

• Is the faucet clean and free of leaks?

  Yes

  No

  N/A

• Is the drain properly sealed and does it have the plug and chain?

  Yes

  No

  N/A

• Is the towel bar secure and in good condition?

  Yes

  No

  N/A

• Is the medicine cabinet secure and in good condition?

  Yes

  No

  N/A

• Is the mirror secure and in good condition?

  Yes

  No

  N/A

• Is the countertop secure and in good condition?

  Yes

  No

  N/A

• Are the cupboards secure and in good condition?

  Yes

  No

  N/A

• Is the toilet clean, secure and in good working order?

  Yes

  No

  N/A

• Is the flush handle in good working order?

  Yes

  No

  N/A

• Is the seat secure and in good condition?

  Yes

  No

  N/A

• Is the toilet paper holder secure and in good condition?

  Yes

  No

  N/A

Bathtub

• Is the faucet clean and leak free?

  Yes

  No

  N/A

• Is the plug and chain attached?

  Yes

  No

  N/A

• Is the shower clean and in good condition?

  Yes

  No

  N/A

• Is the tub surround clean and in good condition?

  Yes

  No

  N/A

• Is the caulking clean and in good condition?

  Yes

  No

  N/A

• Is the soap dish secure and in good condition?

  Yes

  No

  N/A

• Is the face cloth holder secure and in good condition?

  Yes

  No

  N/A

• Are the towel bars secure and in good condition?

  Yes

  No

  N/A

• Is the shower curtain rod secure and in good condition?

  Yes

  No

  N/A

Ensuite

• Is the door to the bathroom in good condition?

  Yes

  No

  N/A

• Are the windows and screens in good condition?

  Yes

  No

  N/A

• Are all the baseboards secure and in good condition?

  Yes

  No

  N/A

• Are the baseboard heaters secure and in good working order?

  Yes

  No

  N/A

• Are the walls and ceilings in good condition?

  Yes

  No

  N/A

• Is the flooring in good condition?

  Yes

  No

  N/A

• Is the light fixture in good condition?

  Yes

  No

  N/A

• Are the light switch and cover secure and in good condition?

  Yes

  No

  N/A

• Is the razor outlet and cover secure and in good condition?

  Yes

  No

  N/A

• Is the exhaust fan or vent clean and in good working order?

  Yes

  No

  N/A

• Are the closet doors and shelving inside secure and in good condition?

  Yes

  No

  N/A

• Is the basin clean and in good condition?

  Yes

  No

  N/A

• Is the faucet clean and in good condition?

  Yes

  No

  N/A

• Is the drain properly sealed and in good condition?

  Yes

  No

  N/A

• Is the towel bar secure and in good condition?

  Yes

  No

  N/A

• Is the medicine cabinet secure and in good condition?

  Yes

  No

  N/A

• Is the mirror secure and in good condition?

  Yes

  No

  N/A

• Is the countertop secure and in good condition?

  Yes

  No

  N/A

• Are the cupboards secure and in good condition?

  Yes

  No

  N/A

• Is the toilet clean, secure and in good working order?

  Yes

  No

  N/A

• Is the flush handle in good working order?

  Yes

  No

  N/A

• Is the seat secure and in good condition?

  Yes

  No

  N/A

• Is the toilet paper holder secure and in good condition?

  Yes

  No

  N/A

Ensuite bathtub

• Is the faucet clean and leak free?

  Yes

  No

  N/A

• Is the plug and chain attached?

  Yes

  No

  N/A

• Is the shower clean and in good condition?

  Yes

  No

  N/A

• Is the tub surround clean and in good condition?

  Yes

  No

  N/A

• Is the caulking clean and in good condition?

  Yes

  No

  N/A

• Is the soap dish secure and in good condition?

  Yes

  No

  N/A

• Is the face cloth holder secure and in good condition?

  Yes

  No

  N/A

• Are the towel bars secure and in good condition?

  Yes

  No

  N/A

• Is the shower curtain rod secure and in good condition?

  Yes

  No

  N/A

Basement

• Is the flooring in good condition?

  Yes

  No

  N/A

• Are the walls in good condition?

  Yes

  No

  N/A

• Are the windows in good condition and working properly?

  Yes

  No

  N/A

• Are the light fixtures in good condition?

  Yes

  No

  N/A

• Is the furnace in good condition?

  Yes

  No

  N/A

• Enter the furnace model number.

• Is the hot water tank in good condition?

  Yes

  No

  N/A

• Enter the model number for the hot water tank.

• Is the washer in good condition?

  Yes

  No

  N/A

• Enter the model number for the washer.

• Is the dryer in good condition?

  Yes

  No

  N/A

• Enter the model number for the dryer.

• Is the pluming in good condition and leak free?

  Yes

  No

  N/A

• Is the floor drain in good condition?

  Yes

  No

  N/A

• Is the wiring secure and in good condition?

  Yes

  No

  N/A

• Is the hydro panel in proper working order?

  Yes

  No

  N/A

• Are the wall plugs secure and safe?

  Yes

  No

  N/A

• Is the hydro meter in good working order?

  Yes

  No

  N/A

• Is the water meter in good working order?

  Yes

  No

  N/A

• Is the gas meter in good working order?

  Yes

  No

  N/A

• Is the handrail secure and in good condition?

  Yes

  No

  N/A

• Are the stairs secure and in good condition?

  Yes

  No

  N/A

Exterior

• Is the exterior of the building in good condition?

  Yes

  No

  N/A

• Is the yard well maintained and clean?

  Yes

  No

  N/A

• Is the sidewalk safe and secure?

  Yes

  No

  N/A

• Is the fence in good condition?

  Yes

  No

  N/A

• Is the roof in good condition?

  Yes

  No

  N/A

• Are the eaves secure and free of debris?

  Yes

  No

  N/A

• Is the chimney in good condition?

  Yes

  No

  N/A

• Is the porch secure and in good condition?

  Yes

  No

  N/A

Garage

• Is the roof in good condition?

  Yes

  No

  N/A

• Are the doors in good condition and working properly?

  Yes

  No

  N/A

• Are the windows in good condition?

  Yes

  No

  N/A

• Are the walls in good condition?

  Yes

  No

  N/A

Miscellaneous

• Is the intercom system working?

  Yes

  No

  N/A

• Are the telephone outlets secure and in good working order?

  Yes

  No

  N/A

• Are the smoke detectors working?

  Yes

  No

  N/A

• Are the batteries in the smoke detector current?

  Yes

  No

  N/A

• Is the units paint in good condition?

  Yes

  No

  N/A

• Is the unit clean?

  Yes

  No

  N/A

Emergency information

Additional comments

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