Nebraska Methodist College

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Previous Inspection

• Have all outstanding actions/issues been completed from the previous audit?

  Yes

  No

  N/A

Student Housing Prohibited items as outline In the Student Handbook.

• Are nails, screws, fasteners, sticky adhesive and tacks may not be used on doors, woodwork or furniture belonging to the college?

  Safe

  At Risk

  N/A

• Are there any screens removed?

  Safe

  At Risk

  N/A

• There are no water beds present?

  Safe

  At Risk

  N/A

• There are no lofts present?

  Safe

  At Risk

  N/A

• Are bicycles being stored on patios or balconies?

  Safe

  At Risk

  N/A

• There are no window boxes, flower boxes or other articles permitted on the sills or hung from the windows or balconies?

  Safe

  At Risk

  N/A

• Is there no additional furniture? Students are allowed to have a TV stand.

  Safe

  At Risk

  N/A

• Is there any evidence of stolen property, e.g., street signs, etc?

  Safe

  At Risk

  N/A

General Safety

• General Area:<br> 1. Temperature Comfortable?<br> 2. Areas free from odors?<br> 3. Ventilation is adequate?<br> 4. Stair treads and handrails present, safe & secured?

  Safe

  At Risk

  N/A

• Are all mirrors secured to the walls and have no cracks or breaks?

  Safe

  At Risk

  N/A

• Are the sink fixtures present, operational with no leaks?

  Safe

  At Risk

  N/A

• Are all countertops secured with surface in good condition?

  Safe

  At Risk

  N/A

• Are doors free from holes and breakage?

  Safe

  At Risk

  N/A

• Is the furniture in good condition with no breaks, tears, sagging, raveling, etc?

  Safe

  At Risk

  N/A

• Are all the floor/table lamps operational?

  Safe

  At Risk

  N/A

• Is all ceiling tile in place and there are no gaps or holes?

  Safe

  At Risk

  N/A

• Is the area free of missing floor tiles?

  Safe

  At Risk

  N/A

• Are the walking surfaces free of slip & trip hazards such as flooring tears, bumps, carpet sags or other trip hazards?

  Safe

  At Risk

  N/A

• Are materials safely stacked and not within 18" vertically or 36" horizontally from the ceiling?

  Safe

  At Risk

  N/A

• Is all the janitorial closets and mechanical rooms secured?

  Safe

  At Risk

  N/A

• Do the dryer vents look clean and properly attached?

  Safe

  At Risk

  N/A

• Evidence of no accumulation of rubbish, garbage or combustible ,<br>Materials in public Areas?

  Safe

  At Risk

  N/A

Life Safety/Fire Management

• Are all entrance/exit doors to egress corridors fully operational?

  Safe

  At Risk

  N/A

• Are smoke detectors operational?

  Safe

  At Risk

  N/A

• Are the lamps clear of clothes, wall hangings, curtains or any other flammable materials?

  Safe

  At Risk

  N/A

• Are the fire extinguishers not obstructed?

  Safe

  At Risk

  N/A

• The fire extinguishers are being checked monthly?

  Safe

  At Risk

  N/A

• Doors are not being propped open?

  Safe

  At Risk

  N/A

• Is the stairways free of storage?

  Yes

  No

  N/A

• Are all "EXIT" lights in good condition, operational and indicate the proper direction of egress?

  Safe

  At Risk

  N/A

• Is all exit door windows clear?

  Safe

  At Risk

  N/A

• The burning of incense and candles are strictly prohibited?

  Yes

  No

  N/A

• Sun/heat lamps, space heaters, window air conditioners and cooking skillets/toaster ovens are prohibited?

  Safe

  At Risk

  N/A

Utilities Management

• Are all the GFCI receptacles in good condition and operational?

  Safe

  At Risk

  N/A

• Electrical extension cords and adapters are not authorized?

  Safe

  At Risk

  N/A

• Are the exterior lighting operational?

  Safe

  At Risk

  N/A

• Are all switches and receptacles mounted and functional?

  Safe

  At Risk

  N/A

• Are there any loose, dangling or exposed wires? Is the wiring properly attached with no expose wires?

  Safe

  At Risk

  N/A

• Are all the electrical panel circuits labeled?

  Safe

  At Risk

  N/A

• Is all electrical panels have a 3' radius and pathway to the panel? All panel doors secured?

  Safe

  At Risk

  N/A

• Is the electrical panel knockouts in place?

  Safe

  At Risk

  N/A

Notes and/or comments

• Report any other conclusions including any other recommendations.

  Yes

  No

  N/A

• Location Photo, certificates, license, etc.

  Media

• Your signature or reply (email) acknowledgement when the corrective actions are scheduled or completed. Important to reply within one week or you'll be non compliant.

  Sign

• Auditors Signature

  Sign

• Inspection scheduled date and time

  Date