Information

  • Conducted on

  • Prepared by

Self contained room handover checklist

  • UNIT

  • Room

  • Resident name

  • Resident present at time of inspection

  • Fire door condition

  • SPECIFY

  • SPECIFY

  • Carpet/Vinyl Condition

  • SPECIFY

  • Chest of Drawers

  • SPECIFY

  • SPECIFY

  • Wardrobe

  • SPECIFY

  • Condition of bed

  • Condition of matress

  • Condition of bedside cabinet

  • SPECIFY

  • SPECIFY

  • Lights

  • SPECIFY

  • Heaters

  • SPECIFY

  • Condition of Walls

  • SPECIFY

  • SPECIFY

  • Condition of smoke detector

  • SPECIFY

  • Condition of Windows

  • SPECIFY

  • Specify

  • SPECIFY

  • Condition of Blinds / curtains

  • Specify

  • Rectify

  • Management informed?

  • MANAGEMENT INFORMED?

  • Condition of bathroom Sink

  • Specify

  • SPECIFY

  • Condition of Toilet

  • Specify

  • SPECIFY

  • Condition of shower enclosure

  • Condition of mirrored Bathroom cabinet

  • Cooker in good working order

  • Cooker requires cleaning

  • Condition of worktop

  • Condition of kitchen sink

  • Room cleaning

  • Are there electrical items in the room that require PAT Testing?

Resident Signature

  • I AM AWARE OF ITEMS ABOVE

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.