• Conducted on

  • Prepared by

  • Location



  • Landscape maintained

  • Parking lot clean

General Area

  • Lighting adequate and operational

  • Temperature is comfortable

  • Area is free from odors

  • Noise level is acceptable/adequately controlled.

  • Ventilation is adequate

  • Stair treads in good condition

  • Handrails present, safe and secure

  • Electrical equipment tested, tagged and safe

  • Electrical switches/sockets in good condition

  • Furniture safe and undamaged

  • Other concerns

  • One side of corridor being used

  • Work space free of clutter

  • Hazard areas secured

  • Doors meet NFPA

  • Other concerns


  • Access and egress paths clear

  • Fire fighting equipment easily accessible

  • Fire fighting equipment checked as required

  • Other concerns


  • Seating available and safe

  • Tables safe and clean

  • Waste and cigarette butt bins available

  • Boundary fences safe and secure

  • Overhead structures safe and secure

  • Out Building is in good condition

  • Gutters and down spout is in good condition

  • Other concerns


  • Equipment secured from resident

  • Other concerns

  • Walking path safe

Boiler room and electrical rooms

  • Breaker panel labeled

  • Fire extinguisher

  • Door secured

  • Maintenance log up to date

  • Fire drills current

  • Other concerns in boiler room

  • Cutter free<br>

  • Other concerns



  • Drains (floor and sink) clear and free flowing

  • Plumbing in good condition

  • Fridge clean, good condition

  • Microwave clean and maintained

  • Oven/stove safe and clean

  • Area free from pests or evidence thereof

  • Self closing doors

  • Breaker panels clear and lock

  • Other



  • Electrical equipment in good condition

  • Lighting operating as designed

  • Floor/area free from water and being wet

  • Rears of dryers clear and clean

  • Folding area cutter free and clean

  • Dryer filter clean

  • Other concerns


  • Bathroom clean and supplied with paper towel and toilet paper

  • Resident rooms odor free

  • Clean behind and under furniture

  • Linen in good condition

  • Room Deep cleaning schedule is available

  • Residents Floors clean

  • Other concerns in residents room

  • Other concerns


  • Good first impression

  • Free of odors

  • Floor maintained

  • Other

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.