Service Environment / Home Safety Inspection Checklist

Step 1 of 5

Service Environment / Home Safety Checklist

Completion Guidelines

In the event of an Emergency/Urgent/Imminent Danger that may cause death and/or a serious injury, halt this inspection and deal with the emergency as appropriate and necessary, the situation must be guarded and rectified immediately. Report the issue to the responsible Manager, and document it in this form after the hazard has been adequately handled.

Review the previous home safety checklist to identify any outstanding actions.
If the situation meets the requirements, indicate it in the 'Yes' column. If it does not meet the requirements, mark it in the "No" column and describe why it did not meet the requirements in the comment/action section.
In the comments/actions section, also indicate what action is necessary to address the issue.
Sign off on the Checklist to retain a copy of the document in the client's file. (The Supervisor may provide additional comments in the Notes/Additional Issues section, if necessary.)
You may identify major outcomes from this assessment at the client team meeting.

Participant's Name*

Date of Inspection*

Inspection Frequency*

Select frequency from dropdown

Checklist Completed by*

Address of Participant*

Step 2 of 5

A. General Cleanliness

Appropriate bins are available at suitable points for general waste, paper, sharps, etc.

YES NO NA

Comments/Required Actions

General and hazardous wastes are emptied and/or removed.

YES NO NA

Comments/Required Actions

Cleaning agents and other chemicals are used and stored safely.

YES NO NA

Comments/Required Actions

Safety Data Sheet (SDS) is available for the chemicals.

YES NO NA

Comments/Required Actions

Toilet and Washrooms are clean and disinfected.

YES NO NA

Comments/Required Actions

Tiles and mirrors are clean.

YES NO NA

Comments/Required Actions

Toilet/s are well stocked with toilet/hand paper.

YES NO NA

Comments/Required Actions

Taps are drip-free when turned off.

YES NO NA

Comments/Required Actions

The service environment is hygienic, clean and tidy.

YES NO NA

Comments/Required Actions

The noise level is appropriate for the participant.

YES NO NA

Comments/Required Actions

The surfaces are dust-free.

YES NO NA

Comments/Required Actions

The service environment is vacuumed.

YES NO NA

Comments/Required Actions

Bed sheets are clean and changed regularly.

YES NO NA

Comments/Required Actions

The equipment, devices, appliances, furniture and fittings that are used by multiple participants are cleaned and disinfected between each use.

YES NO NA

Comments/Required Actions

Step 3 of 5

B. Indoor

Light fittings are clean and in good condition.

YES NO NA

Comments/Required Actions

There is no direct or reflected glare.

YES NO NA

Comments/Required Actions

There are no single fluorescent tubes.

YES NO NA

Comments/Required Actions

There is adequate good natural light.

YES NO NA

Comments/Required Actions

There is adequate ventilation and extraction.

YES NO NA

Comments/Required Actions

Indoor furniture, fittings and equipment are safe, clean, well maintained and suitable for use for the participant and staff.

YES NO NA

Comments/Required Actions

The beds are in good condition.

YES NO NA

Comments/Required Actions

Beds are height-adjustable, fitted with brakes, cotsides fitted and accommodated with lifting.

YES NO NA

Comments/Required Actions

Appropriate slings are available and in good condition, fitted and accommodated with lifting.

YES NO NA

Comments/Required Actions

Other pieces of equipment such as oxygen cylinders, suction machines, etc. are available and serviceable (if applicable).

YES NO NA

Comments/Required Actions

The participant being able to move freely indoors.

YES NO NA

Comments/Required Actions

Step 4 of 5

C. Outdoor

Adequate personal protective clothing and equipment available.

YES NO NA

Comments/Required Actions

Adequate protection from live animals.

YES NO NA

Comments/Required Actions

There is adequate shade, rest and water.

YES NO NA

Comments/Required Actions

Sunscreens with adequate SPF is available and used.

YES NO NA

Comments/Required Actions

Outdoor furniture, fittings and equipment are safe, clean, well maintained and suitable for use by the participant and staff.

YES NO NA

Comments/Required Actions

The heating or cooling equipment maintained regularly.

YES NO NA

Comments/Required Actions

All exits clear.

YES NO NA

Comments/Required Actions

The access/egress paths/floors/walkways are clear and unobstructed.

YES NO NA

Comments/Required Actions

Step 5 of 5

D. Safety

The light switches, plugs, sockets and power points are safe and in good condition.

YES NO NA

Comments/Required Actions

There are no frayed or damaged leads.

YES NO NA

Comments/Required Actions

Electrical heating or cooling equipment are tested and tagged.

YES NO NA

Comments/Required Actions

Portable power tools are in good condition and stored appropriately and safely.

YES NO NA

Comments/Required Actions

There are temporary leads on the floor (trip hazard).

YES NO NA

Comments/Required Actions

The warning signs are available and visible.

YES NO NA

Comments/Required Actions

There are clear, non-slip floors.

YES NO NA

Comments/Required Actions

The first aid kit is clearly labelled and easily accessible.

YES NO NA

Comments/Required Actions

First aid kit and its contents are appropriate to use for the first aid assessment and provision.

YES NO NA

Comments/Required Actions

Emergency evacuation procedure is available and easily visible.

YES NO NA

Comments/Required Actions

The fire extinguisher is available, clearly marked and accessible.

YES NO NA

Comments/Required Actions

The fire extinguisher is regularly inspected and serviced.

YES NO NA

Comments/Required Actions

Fire and Smoke Alarms are installed properly.

YES NO NA

Comments/Required Actions

Fire alarm with flashing light or vibrating component available for hearing impaired people.

YES NO NA

Comments/Required Actions

Fire and smoke detectors are working.

YES NO NA

Comments/Required Actions

Adequate pointers to fire exits are marked and available.

YES NO NA

Comments/Required Actions

Exit signs are adequately laminated and illuminated.

YES NO NA

Comments/Required Actions

Aisle and floors are free of obstruction and trip hazards.

YES NO NA

Comments/Required Actions

Hand sanitiser and masks are available and used to protect the participants and workforce from Epidemics and pandemics such as flu & COVID-19.

YES NO NA

Comments/Required Actions

Appropriate handrails are available on the stairs (if applicable).

YES NO NA

Comments/Required Actions

Trained inducted workers and staff are available.

YES NO NA

Comments/Required Actions

Relevant Policy and Procedures are available.

YES NO NA

Comments/Required Actions

The available worker and staff is trained on Providing First Aid.

YES NO NA

Comments/Required Actions

Any additional information (if applicable)

Acknowledgement

I have completed the report to the best of my knowledge and ability. I have informed the participant for the purpose of this report. The participant actively participated in the preparation of this report.

Signature*

Report Completion Date

Your responses are submitted securely and stored in Care Zone's confidential records.