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?

GENERAL HAZARDS

  • 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?

DETERIORATION OF THE EQUIPMENT

  • 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?

SECURITY OF HARDWARE

  • 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

ACTIONS TAKEN ON HAZARDS APPARENT FROM THIS INSPECTION:

  • NOTES:

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.