ODLE - Dormitory Inspection

• Center Name

  Select ALBUQUERQUE JCC - 1500 Indian School Road NW, Albuquerque, NM. 87104 DAVID L. CARRASCO JCC - 1115 Gateway Blvd, El Paso, TX. 79935 Denison JCC - 10 Opportunity Drive, Denison, IA. 51442 OLD DOMINION JCC - 1073 Father Judge Road, Monroe, VA. 24574 Paul Simon JCC - 3348 S. Kedzie Avenue, Chicago, IL. 60623 PINELLAS COUNTY JCC - 500 22nd Street S, St. Petersburg, FL. 33712 PITTSBURGH JCC - 7175 Highland Drive, Pittsburgh, PA. 15206 Potomac JCC - 1 DC Village Lane SW, Washington, D.C. 20032 Turner JCC - 2000 Schilling Avenue, Albany, GA. 31705 Jacksonville JCC - 4811 Payne Stewart Drive, Jacksonville, FL. 32209

  • ALBUQUERQUE JCC - 1500 Indian School Road NW, Albuquerque, NM. 87104
  • DAVID L. CARRASCO JCC - 1115 Gateway Blvd, El Paso, TX. 79935
  • Denison JCC - 10 Opportunity Drive, Denison, IA. 51442
  • OLD DOMINION JCC - 1073 Father Judge Road, Monroe, VA. 24574
  • Paul Simon JCC - 3348 S. Kedzie Avenue, Chicago, IL. 60623
  • PINELLAS COUNTY JCC - 500 22nd Street S, St. Petersburg, FL. 33712
  • PITTSBURGH JCC - 7175 Highland Drive, Pittsburgh, PA. 15206
  • Potomac JCC - 1 DC Village Lane SW, Washington, D.C. 20032
  • Turner JCC - 2000 Schilling Avenue, Albany, GA. 31705
  • Jacksonville JCC - 4811 Payne Stewart Drive, Jacksonville, FL. 32209

• Inspection Date

  Date

• Inspected by

• Name of Dormitory(s) Inspected

INSPECTION REQUIREMENT

• Per PRH 5.9 R5, dormitories must be inspected monthly by the Center Safety Officer.

STRUCTURAL INTEGRITY

• Floors: clean, cleanable, in good repair

  Yes

  No

  N/A

• Walls and ceilings: clean, paint in good condition, cleanable

  Yes

  No

  N/A

• Foundation structurally sound ; no water leaks or flooding; walls and ceilings intact

  Yes

  No

  N/A

• Windows and doors not broken; open and close as designed

  Yes

  No

  N/A

• Stairways, stair tread and hand rails: in good repair; and free of trip hazards

  Yes

  No

  N/A

• Exterior walls and gutters are free of defects; and gutters are secured to building, and free of sagging, holes, cracks and leaks

  Yes

  No

  N/A

GENERAL HEALTH AND SAFETY

• No evidence of vermin, insects or rodents. Outer openings protected.

  Yes

  No

  N/A

• Ventilation adequate, no odors or moisture

  Yes

  No

  N/A

• Cleaning supplies, mops, brooms properly stored

  Yes

  No

  N/A

• Carpets and floor coverings securely fastened

  Yes

  No

  N/A

• Windows, sills, curtains, screens, shades: clean and in good repair

  Yes

  No

  N/A

• Lighting adequate, fixtures clean

  Yes

  No

  N/A

• Water fountains clean and working properly

  Yes

  No

  N/A

• First aid kits are stocked and conveniently located

  Yes

  No

  N/A

• AED is operational, with batteries and pads within the expiration dates

  Yes

  No

  N/A

• Enter location of AED that was inspected

• Safety Data Sheets (SDS) are maintained and conveniently located (SDS are on file for all chemicals; MSDS have been replaced with SDS)

  Yes

  No

  N/A

• Emergency eyewash station is inspected and flushed regularly; functioning properly

  Yes

  No

  N/A

FIRE AND ELECTRICAL SAFETY

• Fire extinguishers accessible, charged

  Yes

  No

  N/A

• Fire escapes, accessible, marked, unlocked; periodic fire drills conducted

  Yes

  No

  N/A

• Evacuation route maps posted; no smoking signs posted; designated smoking areas marked

  Yes

  No

  N/A

• Flammable liquids, oily rags and waste properly stored; No fire hazards

  Yes

  No

  N/A

• Alarm system functioning properly; exit signs illuminated; smoke detectors working properly

  Yes

  No

  N/A

• Emergency lighting/Exit Signs functioning properly<br>(functional testing should be conducted by pressing the "push to test" button for a minimum of 30 seconds).

  Yes

  No

  N/A

• Fire Sprinkler Systems: in good condition with no visible damage; free of external leaks

  Yes

  No

  N/A

• 18” clearance maintained between sprinkler heads and stored items

  Yes

  No

  N/A

• Electrical installations adequate

  Yes

  No

  N/A

• GFCIs functioning properly

  Yes

  No

  N/A

BATHROOMS (Common and Individual)

• Toilets: adequate in number, in good repair, clean, toilet paper available

  Yes

  No

  N/A

• Showers and tubs: in good repair, hot and cold water, clean, mildew free

  Yes

  No

  N/A

• Sinks: clean, in good repair, hot and cold water, soap available, drying device available

  Yes

  No

  N/A

• Adequate ventilation, no odors or moisture

  Yes

  No

  N/A

• Plumbing installations and drains adequate

  Yes

  No

  N/A

• Rubbish containers: provided, adequate, clean, emptied daily

  Yes

  No

  N/A

Dormitories

• Only approved electrical appliances are used in dorm rooms

  Yes

  No

  N/A

• Lockers and clothing storage adequate, clean, and in good repair

  Yes

  No

  N/A

• Soiled linen: properly stored and handled

  Yes

  No

  N/A

• Beds: clean, in good repair, free of vermin

  Yes

  No

  N/A

• Blankets and linens clean and dust-free

  Yes

  No

  N/A

• Mattress covers in use, clean

  Yes

  No

  N/A

• Laundry room equipment functioning properly; clothes dryers vented and lint traps cleaned regularly

  Yes

  No

  N/A

• Washers and dryers grounded; GFCIs functioning properly

  Yes

  No

  N/A

Additional Comments/Information/Photos

• Any further comments or recommendations from this inspection?

• Add any additional relevant photos

  Media

Completion

• All persons involved in the inspection will sign below

• Signature of Inspector

  Sign

• Dorm Supervisor/Manager/Director (If involved in the inspection)

  Sign

• Name of others involved in inspection

  Sign