TST BOCES WORK ENVIRONMENT HEALTH & SAFETY PLAYGROUND INSPECTION CHECKLIST

• School District

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

PLAYGROUND SITE and LOCATION

• Signs and Rules posted (ASTM 14.1, CPSC 2.2.6)

  Yes

  No

  N/A

• Is the Equipment age-appropriate? (ASTM 4.2.1, CPSC 2.2.3, CPSC 5.3.2, CPSC 5.3.2.5, CPSC 5.3.6)

  Yes

  No

  N/A

• Are trees/over growth trimmed back from playground equipment and healthy? (ASTM 9.8.4.1, CPSC 4.1 - Table 3)

  Yes

  No

  N/A

• Is site clear of all dangerous and unsuitable objects? (ASTM 13.1.2, CPSC 4.1)

  Yes

  No

  N/A

• Is the area free of graffiti? (CPSC 4.1)

  Yes

  No

  N/A

PLAY AREA BORDER

• Is there a perimeter present around the play area?

  Yes

  No

  N/A

• Is the perimeter contrasting in color? (ASTM 3.1.50, CPSC 3.6)

  Yes

  No

  N/A

• Condition of Material (CPSC 2.4.2.2, ASTM F 2223-13.1)

  Good

  Fair

  Poor

  N/A

SURFACING

• Is there the required impact-absorbing material around the fall zones of equipment? (CPSC 2.4.2.2, ASTM F 2223-13.1)

  Yes

  No

  N/A

• Is site free from ponding or surface water? (ASTM 13.2.1, CPSC 4.3)

  Yes

  No

  N/A

• Type of Surfacing Material

• Depth of Surfacing Material (CPSC 2.4.2.2, ASTM F 2223-13.2.1)

  Safe

  At Risk

  N/A

ADA ACCESSIBILITY (ASTM F1487-17, 10.)

• Is ADA Accessibility compliant? (ASTM Section 7 Requirements for Access/Egress) (DOJ ADA 2010)

  Yes

  No

  N/A

PLAY EQUIPMENT

• HARDWARE: Are all fasteners and connecting devices in place and securely fastened? (ASTM 3.1.27, ASTM 12.1, ASTM 13.1, CPSC 2.5.2, CPSC 5.3.6)

  Yes

  No

  N/A

• PROTRUSIONS: Equipment free of protrusion hazards? ( ASTM 6.3, ASTM 6.4, CPSC 3.2 CPSC 3.6)

  Yes

  No

  N/A

• ENTANGLEMENTS: Equipment free of entanglement hazards? (CPSC 3.2, CPSC, 3.2.1)

  Yes

  No

  N/A

• CRUSH AND SHEER: Equipment free of crush and sheer hazards? (ASTM 6.5, CPSC 3.1, CPSC 3.4)

  Yes

  No

  N/A

• ENTRAPMENTS: Equipment free of entrapment hazards? (ASTM 6.1, CPSC 3.3.1, CPSC B 2.4)

  Yes

  No

  N/A

• SHARP POINTS, CORNERS, EDGES: Equipment free of sharp points, corners and edges? (ASTM 3.1.37, CPSC 3.4)

  Yes

  No

  N/A

• GUARDRAILS and BARRIERS: Are guardrails and barriers in compliance? (CPSC 5.1.3

  Yes

  No

  N/A

• Are all the post foundations firm? (ASTM 10.1.2, CPSC 2.6)

  Yes

  No

  N/A

• Is the equipment complete with no missing parts? (ASTM 6.5.1.1, ASTM 8.6.3, ASTM 12.1, CPSC 3.1, CPSC 4.2, CPSC 4.3, CPSC 5.3.8)

  Yes

  No

  N/A

• Chains in good condition? (ASTM 3.1.37, CPSC 2.5.1, CPSC 5.3.8, CPSC 5.3.8.1)

  Yes

  No

  N/A

• Chain coatings in good condition , free of cracking? (ASTM 5.3.8.1, ASTM 3.1.37 , CPSC 2.4.1)

  Good

  Fair

  Poor

  N/A

• Connectors (chains, D- clamps, S - hooks etc...) satisfactory? (ASTM 6.4.5, ASTM 6.4.5.1, CPSC 5.3.8, CPSC 5.3.8.1)

  Safe

  At Risk

  N/A

• Tunnels undamaged and free from obstructions? (ASTM 3.1.37, CPSC 3.4)

  Yes

  No

  N/A

• Rotating items moving freely on their bearings? (ASTM 3.1.35, ASTM 9.3.3, CPSC 5.3.3 , CPSC 5.3.4)

  Yes

  No

  N/A

• Springs free from cracking or fatigue? (ASTM 8.11, CPSC 5.3.7)

  Yes

  No

  N/A

• Rope/flexible climbers in good condition? (ASTM 3.1.5 CPSC 5.3.2.3)

  Yes

  No

  N/A

• Ropes, Cables and Chains are attached and anchored at both ends (ASTM 3.1.5, ASTM 6.6.1 CPSC 4.2)

  Yes

  No

  N/A

• Arch Climbers in on good condition and age appropriate? (ASTM 4.2.1, ASTM 7.3.2.1, CPSC 2.2.3, CPSC 2.5.2, CPSC 5.3.2.2)

  Yes

  No

  N/A

• Track Rides compliant and in good condition? (ASTM 4.2.1, ASTM 8.13, CPSC 8.13)

  Yes

  No

  N/A

• Seesaw Equipment and surrounding material (ASTM 8.10, ASTM 13.1, CPSC 5.3.2.1.4)

  Yes

  No

  N/A

• Are the protective coating intact and good condition? (ASTM 4.1.1, CPSC 2.5.1, CPSC 2.5.4)

  Yes

  No

  N/A

• Supervision: Do supervision areas overlap? (ASTM, CPSC 2.2.5, CPSC 2.2.7)

  Good

  Fair

  Poor

  N/A

SLIDES

• Slide discharges have enough impact absorbing material? (ASTM F 2223-13.1, CPSC 2.4.2.2, 5.3.6.4)

  Yes

  No

  N/A

• Slide discharge height in compliance? (ASTM 8.5.5.3)

  Yes

  No

  N/A

• Are slide use zones and clearances free of obstructions? (ASTM 8.5.6)

  Yes

  No

  N/A

• Does slide entrance offer means of transition to sitting position? (ASTM 8.5.3, CPSC 5.3.6.2)

  Yes

  No

  N/A

• ENTANGLEMENTS: Are slides free of entanglements? (CPSC 3.2, CPSC, 3.2.1)

  Yes

  No

  N/A

• PROTRUSIONS: Are slides free of protrusions? ( ASTM 6.3, ASTM 6.4, CPSC 3.2 CPSC 3.6, CPSC B 2.3)

  Yes

  No

  N/A

• Are sliding surfaces undamaged (burning or cracking)? (ASTM 3.1.37 , CPSC 2.5.3)

  Yes

  No

  N/A

SWINGS

• Does swing structures have a 72in use zone unobstructed? (CPSC 9.2.1, ASTM CPSC 5.3.8.3.3)

  Yes

  No

  N/A

• Do swings have unobstructed use zones? (Single axis - ASTM 9.4.1.1, CPSI 5.3.8.8.3, Multi-axis - ASTM 9.4.2.1, CPSC [milti-axis] 5.3.8.4.1)

  Yes

  No

  N/A

• Are chains in good condition? (ASTM 3.1.37, CPSC 2.5.1, CPSC 5.3.8, CPSC 5.3.8.1)

  Yes

  No

  N/A

• Are chain coatings in good condition , free of cracking? (ASTM 5.3.8.1, ASTM 3.1.37 , CPSC 2.4.1)

  Yes

  No

  N/A

• Swing seats in good condition? (ASTM 3.1.37, CPSC 3.4, CPSC 5.3.8, CPSC 5.3.8.1)

  Yes

  No

  N/A

• Do swing seat heights allow access? (ASTM 8.6.5.1, CPSC 5.3.8.1 Table 7)

  Yes

  No

  N/A

• Are all S-Hooks free of entanglement hazards? (ASTM 6.4.5.1, CPSC 5.3.8.1)

  Yes

  No

  N/A

• Is the equipment complete with no missing parts? (ASTM 6.5.1.1, ASTM 8.6.3, ASTM 12.1, CPSC 3.1, CPSC 4.2, CPSC 4.3, CPSC 5.3.8)

  Yes

  No

  N/A

ADDITIONAL COMMENTS:

• Other maintenance items:

  Yes

  No

  N/A

• Comments

  Media

Certifications

• Mark J. Alo

  Sign

• CPSI Number: 50406-0224

  Sign