Title Page

  • Conducted on

  • Prepared by

  • Location
  • Required checklist is to be completed by the school principal, playground aide, day care teacher or the custodian

  • School: Checked by: Date:

  • Check:

  • 1. Does the equipment have adequate protective surfacing under and around it (12-14‚Äúsand, crushed (if no, explain. Use note portion or the back of this sheet)

  • SURFACING: wood or equivalent protection)?

  • 2. Is the loose-fill surfacing material free of foreign objects or debris?

  • 3. Is the loose-fill surfacing material loose and un-compacted and of sufficient depth in heavy use areas such as under swings or at slide exits?


  • 4. Is all equipment free of sharp points, or dangerous corners or edges?

  • 5. Are all pipe ends covered with undamaged protective caps or plugs?

  • 6. Are all hazardous protrusions and projections, such as bars or bolts, removed?

  • 7. Are all potential clothing entanglement hazards removed or repaired (e.g. open S-hooks or protruding bolts)?

  • 8. Have you insured that there are no pinch, crush, or shearing points or any exposed moving parts?

  • 9. Is the playground area free of any trip hazards, such as exposed footings and anchoring devices, and rocks, roots, or any other environmental obstacles?


  • 10. Is all equipment free of rust, rot, cracks or splinters, especially where it comes in contact with the

  • 11. Are all components on the playground equipment unbroken and in good condition (e.g. handrails, guardrails, protective barriers, steps or rungs on ladders)?

  • 12. Are all fences, benches, and signs on the playground in an undamaged condition?

  • 13. Is all equipment securely anchored?


  • 14. Are all fastening devices and connections, such as S-hooks and chains, secure and in good condition?

  • 15. Are moving components, such as swing hangers, swing rings or nets, unworn and safe?

  • 16. Does the entire play area have satisfactory drainage, especially in heavy use areas such as under swings

DRAINAGE and slide areas?

  • 17. Is the entire playground free from miscellaneous debris or litter such as branches, cans, glass, animal

  • GENERAL UPKEEP OF PLAYGROUNDS none: no hazardous conditions found


  • NOTES:

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