High-Frequency Playground Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Inspection Items

• Vandalism: damage, graffiti, glass, trash

  Safe

  At Risk

  N/A

• Remove foreign objects: rope, litter, wood

  Safe

  At Risk

  N/A

• Loose or missing hardware

  Safe

  At Risk

  N/A

• Chains: kinked, twisted, broken

  Safe

  At Risk

  N/A

• Guardrails/handrails secure

  Safe

  At Risk

  N/A

• Seats: cut, crack, missing

  Safe

  At Risk

  N/A

• Wood: rotten, cracked, missing

  Safe

  At Risk

  N/A

• Sweep walkways, platforms, steps

  Safe

  At Risk

  N/A

• Footers exposed

  Safe

  At Risk

  N/A

• Standing water

  Safe

  At Risk

  N/A

• Objects in surfacing material

  Safe

  At Risk

  N/A

• Rake/level surfacing material

  Safe

  At Risk

  N/A

Item has sufficient surfacing material:

• Swings

  Yes

  No

  N/A

• Climbers

  Yes

  No

  N/A

• Slide

  Yes

  No

  N/A

• Fire pole

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

For office use only:

• Reviewed by CPSI:

  Sign