Title Page

  • Document No.

  • Site name

  • Conducted on

  • Prepared by

  • Site address

Communal pathways

  • Are all pathways safe to use?

  • Description

  • Pictures

Communal shared areas - grass or paved

  • Include bin areas, drying areas, cycle stores

  • Are all shared areas safe to use?

  • Description

  • Pictures

Communal internal areas

  • Check for obstructions, storage, blocked escape routes, slip and trip hazards

  • Are all internal areas safe to use?

  • Description

  • Pictures

Evidence of compliance

  • Have you recorded any unsafe areas?

  • Please take some pictures of the site to confirm it is safe

  • Pictures


  • Visits per year

  • Action code

  • Any additional concerns?

  • Concerns

  • Pictures

  • Name

Email to: slips_and_trips@broadlandgroup.org

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.