Lauren Gordon

UCPS ASP Playground Inspection Checklist

Rule 10A NCAC 09.0605 requires this inspection checklist to be completed monthly by a staff person who has received the four hour training in safety (10A NCAC 09.0705(e))

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Title Page

Document No.
School Name
Conducted on
Prepared by

General Inspection

Playground area free of litter and debris
Equipment not damaged or vandalized

Surfacing

Adequate depth of surface under and around equipment
Surfacing material free of glass, debris, or other foreign objects

General Hazards

Equipment free of sharp points, corners or edges
Protective caps or plugs not missing or damaged
Equipment free of potential clothing entanglement hazards
Playground area free of tripping hazards

Deterioration of Equipment

Equipment and playground area free from presence of rot, rust, cracks, and splinters
Equipment safely anchored

Security of Hardware

Equipment connection, covering or fastening hardware devices not loose or worn

Equipment Use Zones

Equipment use zones free of obstacles

Drainage Systems

Playground area free from drainage problems
Signature

Lauren Gordon

UCPS ASP Playground Inspection Checklist

Rule 10A NCAC 09.0605 requires this inspection checklist to be completed monthly by a staff person who has received the four hour training in safety (10A NCAC 09.0705(e))

Use this Template

Print as PDF

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