Information

  • Region:

  • Jamatkhana/Facility Name:

  • Date of Inspection:

  • Property Type:

  • Inspection Started:

  • Prepared by:

  • Local IMARA Representative:

  • Comments:

Security

  • Region:

  • Jamatkhana/Facility:

  • Current Security System (Building):

  • Company Name:

  • Cost per month (Building ONLY):

  • Current Security System (Daftary):

  • Cost per month (including Daftary):

  • Is Security Alarm System being used for Entry Doors on regular basis:

  • Renewal Options (Annual/Quarterly):

  • Renewal Notice:

  • Building Code Compliant

  • Safety/Security Compliant:

  • ADA Compliance - Adequate Accommodation for Individuals with Physical Disabilities

  • Evacuation Maps visible throughout facility

  • Contract/Break Clause:

  • Camera System:

  • Equipment Used:

  • Current Protocol for Monitoring:

  • Inspector Signature:

Landscaping

Irrigation System

  • Irrigation System:

  • Overall Irrigation System:

  • Holes due to broken lines: (If so, how many)

  • Heads in lawns/grass area:

  • Lids missing from LG heads: (If so, how many)

  • Valve Box Covers:

  • Irrigation system over-sprays:

  • Wet Spot due to low head online:

  • Water Stain(s) on Building:

Trees, Plants and Bushes

  • Overall Condition of Trees:

  • Trimming of trees:

  • Plants/Bushes:

  • Roots along sidewalks:

  • Branches obstructing lights or signage:

  • Large dead wood in big trees:

Lawn Care

  • Lawn Care/Health of Grass or Turf:

Other Comments, Pictures and References

  • Other:

  • Comments:

  • Overall Cleanliness/Appearance:

  • Pictures/Media/Reference:

Parking Lot

  • General Condition:

  • Paving/Seal Coating/Striping:

  • Curb Appeal:

  • Handicap Entrances:

  • Center Entrances:

  • Cleanliness:

  • Oil Spots:

  • Leaves/Drain Covers:

  • Electrical Vaults/Panels/Boxes:

  • Light Fixtures/Poles:

  • Truck/Loading Docks:

  • Trash Removal:

  • Trash Containers/Gates/Area:

  • Sweeping

  • Drainage:

  • Bike Racks:

  • Abandoned Cars:

  • Striping at Crosswalks:

  • Cracks/Potholes:

  • Sidewalks/Walkways:

  • Handicap Parking Signage:

  • Traffic Signage:

  • Speed Bumps:

Other Comments, Pictures and References:

  • Other:

  • Comments:

  • Overall Cleanliness/Appearance:

  • Pictures/Media/Reference:

Exterior

Building

  • Building Entrance:

  • Doors:

  • Hinges:

  • Locks:

  • Side Lights:

  • Street Numbers:

  • Entry Area/Steps:

  • Lighting:

Signage

  • Property/Pylon:

  • Parking Lot:

  • Handicap Spaces:

  • Tenant/Store Sign:

  • Directory Listing: (Office Park/Building)

  • Traffic Signage:

  • Directional Signs:

Building Exterior

  • Foundation/Slab:

  • Exterior Masonry:

  • Walls/Fences:

  • Canopy/Sign Band:

  • Gutter/Downspouts:

  • Graffiti:

  • Location:

  • Picture Reference:

  • Canopy Supporting Columns:

  • Rear Doors:

  • Exterior Building Lights:

Windows

  • Glass:

  • Glazing:

  • Caulking:

Other Comments, Pictures and References:

  • Other:

  • Comments:

  • Overall Appearance:

  • Pictures/Media/Reference:

Roof

Roof

  • Free of Debris:

  • Surface Condition:

  • Drainage:

  • Gas Line jacks:

  • Flashing:

  • Parapet Walls:

  • Ladder Access:

  • Roof Screens:

  • Roof Hatch Locks:

  • Skylights:

  • Expansion joints:

  • Coping:

  • Pitch pans:

  • Penetrations (Vents, AC units):

Other Comments, Pictures, Recommendations

  • Other:

  • Comments:

  • Overall Appearance/Condition:

  • Pictures/Media/Reference:

Lobby

Main Lobby Area:

  • Ceiling:

  • Walls:

  • Floors/Carpeting:

  • Ceiling Fans:

  • Emergency Lights:

  • Fire Extinguishers:

  • Smoke Detectors:

  • Drapes/Blinds:

  • Light Fixtures:

  • Fixtures:

  • Furniture:

  • Equipment:

Other Comments, Pictures and References:

  • Other:

  • Comments:

  • Overall Appearance/Cleanliness:

  • Pictures/Media/Reference:

Prayer Hall/Anteroom

Prayer Hall

  • Ceiling:

  • Walls:

  • Floors:

  • Emergency Lights:

  • Fire Extinguishers:

  • Smoke Detectors:

  • Drapes/Blinds:

  • Ceiling Fans:

  • Light Fixtures:

  • Fixtures:

  • Furniture:

  • Equipment:

  • Doors:

Anteroom/Sitting Area

  • Ceiling:

  • Walls:

  • Floors/Carpeting:

  • Emergency Lights:

  • Fire Extinguishers:

  • Smoke Detectors:

  • Drapes/Blinds:

  • Ceiling Fans:

  • Light Fixtures:

  • Fixtures:

  • Furniture:

  • Equipment:

Other Comments, Pictures, References:

  • Other:

  • Comments:

  • Overall Cleanliness/Appearance:

  • Pictures, References, Media:

Social Hall/Library/Courtyards

Social Hall/Courtyard(s)

  • Ceiling:

  • Walls:

  • Floors/Carpeting:

  • Emergency Lights:

  • Fire Extinguishers:

  • Smoke Detectors:

  • Drapes/Blinds:

  • Ceiling Fans:

  • Light Fixtures:

  • Fixtures:

  • Furniture:

  • Equipment:

Library/Resource Room:

  • Ceiling:

  • Walls:

  • Floors/Carpeting:

  • Emergency Lights:

  • Fire Extinguishers:

  • Smoke Detectors:

  • Drapes/Blinds:

  • Ceiling Fans:

  • Light Fixtures:

  • Fixtures:

  • Furniture:

  • Equipment:

Other Comments, Pictures, References:

  • Other:

  • Comments:

  • Overall Cleanliness/Appearance:

  • Pictures, References, Media:

Offices/Preparatory

Administrative Offices

  • Ceiling:

  • Walls:

  • Floors/Carpeting:

  • Emergency Lights:

  • Fire Extinguishers:

  • Smoke Detectors:

  • Drapes/Blinds:

  • Ceiling Fans:

  • Light Fixtures:

  • Fixtures:

  • Furniture:

  • Equipment:

Kitchen/Prep Area:

  • Ceiling:

  • Walls:

  • Floors/Carpeting:

  • Emergency Lights:

  • Fire Extinguishers:

  • Smoke Detectors:

  • Drapes/Blinds:

  • Ceiling Fans:

  • Light Fixtures:

  • Fixtures:

  • Furniture:

  • Equipment:

Other Comments, Pictures, References:

  • Other:

  • Comments:

  • Overall Cleanliness/Appearance:

  • Pictures, Media, Reference:

Shoes/Cloak

Shoes/Cloak Area:

  • Ceiling:

  • Walls:

  • Floors/Carpeting:

  • Emergency Lights:

  • Fire Extinguishers:

  • Smoke Detectors:

  • Drapes/Blinds:

  • Ceiling Fans:

  • Light Fixtures:

  • Fixtures:

  • Furniture:

  • Equipment:

Other Comments, Pictures, Reference:

  • Other:

  • Comments:

  • Overall Cleanliness/Appearance:

  • Other Pictures, Reference, Media:

REC

RE Classrooms/Principal/Administrator Area

  • REC Room:

  • REC Room
  • Room Name:

  • Ceiling:

  • Walls:

  • Floors/Carpet:

  • Emergency Lights:

  • Drapes/Blinds:

  • Light Fixtures:

  • Ceiling Fans:

  • Furniture:

  • Fixtures:

  • Equipment:

  • Evacuation Plan Posted:

  • Include Picture of Evacuation Plan:

  • Fire Extinguisher(s):

  • Smoke Detectors:

  • Principal/Administrator Area or Office:

ECD Classroom(s)

  • Location of Equipment (Please List):

  • ECD Classroom(s)

  • ECD Room:
  • Room Name:

  • Ceiling:

  • Walls:

  • Floors/Carpet:

  • Emergency Lights:

  • Drapes/Blinds:

  • Light Fixtures:

  • Ceiling Fans:

  • Furniture:

  • Fixtures:

  • Equipment:

  • Evacuation Plan Posted:

  • Include Picture of Evacuation Plan:

Other Comments, Pictures, References:

  • Other:

  • Comments:

  • Overall Cleanliness/Appearance:

  • Pictures, Media, References:

Storage Room(s)

Storage Area(s)

  • Storage Area(s)

  • Storage:
  • Name of Storage Area:

  • Ceiling:

  • Walls:

  • Floors/Carpeting:

  • Emergency Lights:

  • Light Fixtures:

  • Fixtures:

  • Furniture:

  • Equipment:

Other Comments, Pictures, References:

  • Other:

  • Comments:

  • Pictures, Media, Reference:

Restrooms

Women's Restroom (Main):

  • Entrance:

  • Floor Covering:

  • Walls:

  • Ceiling:

  • Dispensers:

  • Lighting:

  • Trash Receptacles:

  • ADA Compliance:

  • Sinks:

  • Signs:

  • Mirrors:

  • Fixtures:

  • Furniture:

  • Equipment:

  • Overall Cleanliness/Appearance:

Men's Restroom (Main):

  • Entrance:

  • Floor Covering:

  • Walls:

  • Entrance:

  • Ceiling:

  • Dispensers:

  • Lighting:

  • Trash Receptacles:

  • ADA Compliance:

  • Sinks:

  • Signs:

  • Mirrors:

  • Fixtures:

  • Furniture:

  • Equipment:

  • Overall Cleanliness/Appearance:

  • Other Facility Restroom(s):

  • Restroom:
  • Location:

  • Entrance:

  • Floor Covering:

  • Walls:

  • Entrance:

  • Ceiling:

  • Dispensers:

  • Lighting:

  • Trash Receptacles:

  • ADA Compliance:

  • Sinks:

  • Signs:

  • Mirrors:

  • Fixtures:

  • Furniture:

  • Equipment:

  • Overall Cleanliness/Appearance:

Water Fountains

  • Water Fountain Area:

  • Water Fountain -
  • Location:

  • Working Condition:

  • Any Leaks?

  • Picture Reference:

Other Comments, Pictures, References:

  • Other:

  • Comments:

  • Pictures, Media, Reference:

Fire Safety

Safety/Preparedness

  • Fire Hydrant(s):

  • Building Connections:

  • Sprinkler System:

  • Alarm System:

  • Name of Fire Panel Company:

  • Date of Last Fire Panel Test:

  • Date of Last Fire Drill:

  • Date of Last Evacuation Drill:

  • Exit Signs:

  • Exit Door Locks:

  • Number of Exit Doors:

  • List Exit Door Locations:

  • First Aid Kit Information:

  • First Aid Kit -
  • Location of First Aid Kit:

  • Condition:

  • Picture Reference:

  • Emergency Preparedness Kit:

  • Kit -
  • Location of Emergency Preparedness Kit:

  • Condition:

  • Picture Reference:

HVAC/Thermostats

HVAC System & Equipment

  • HVAC System

  • HVAC Unit -
  • System Type:

  • Description of System:

  • Location of Equipment (Please List):

  • Location of Equipment (Please List):

  • Location of Equipment (Please List):

  • Area Covered:

  • Overall Condition:

  • All Panels Mounted and Secured:

  • Coil Cleanliness:

  • Condensation Pan Clogged or Leaking:

  • Signs of Physical Damage:

  • Signs of External Corrosion:

  • Signs of Oil Leaks:

  • Signs of Biological Growth:

  • Signs of Asbestos Insulation:

  • Noise and Vibrations:

  • Insulation:

  • Electrical and Control Panels:

  • Air Ducts:

  • Filters:

  • Please replace filters as soon as possible to ensure efficiency and proper energy consumption.

  • Monitor filters and please be sure to replace in a timely manner

  • Signs of Internal Corrosion and/or Leaks:

  • Air Diffusers Clean & Secured:

  • Maintenance Requirements:

  • Describe Requirements/Recommendations:

Thermostats:

  • Thermostat Information:

  • Thermostat -
  • Make:

  • Model:

  • Location:

  • Sensor Location/Area Covered:

  • Comments:

  • Thermostat Picture:

Elevator

  • Elevator Information:

  • Elevator -
  • Location:

  • Doors:

  • Tracks:

  • Lighting Fixtures:

  • Flooring:

  • Ceiling:

  • Appearance (Interior):

  • Emergency Assistance:

  • Date Last Inspected:

  • Inspector/Inspection Company:

  • Elevator Certificate on File:

Final Summary

Final Summary

  • Inspection Summary (Please include 2-3 sentences):

  • Additional Reference Items (Please include here):

  • Inspection Complete:

  • Inspector Signature (Please validate before completion):

  • Is there CAD Drawing of JK?

  • Include Picture of CAD Drawing:

Other Areas/Rooms

Additional Rooms/Areas

  • Other Room/Area:

  • Room/Area -
  • Name of Room/Area:

  • Location of Room/Area (ie: Basement, 1st Floor behind social hall):

  • Ceiling:

  • Walls:

  • Floors:

  • Light Fixtures:

  • Fixtures:

  • Furniture:

  • Equipment:

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.