Foster Home Safety Checklist Template printable pdf download

Foster Home Safety Checklist Template

Home: ___________________________

Date: __________________

Address:

________________________________________

Social Worker: ____________________________

Check One:

Semi-Annual

Initial

Preliminary

FOSTER HOME SAFETY CHECKLIST

GENERAL

_____ Telephone service connected, phones working properly, easily & accessible.

Emergency numbers are posted within view of phone.

_____ Well water clearance must be obtained if water is from a private source.

_____ House appears reasonably neat and clutter free.

_____ Windows have screens in good repair.

_____ Windows have curtains or shades to provide privacy.

_____ Windows are intact and open windows can be closed without difficulty.

_____ Carpets are clean and in good repair.

_____ Floors are clean and in good repair.

_____ Ceilings, corners, closets, and window frames are free of dirt and cobwebs.

_____ Electrical switches and receptacles are in good working order.

_____ Type of heating, ________________________, is in good working order, well

vented, and able to be turned off.

_____ Heating capable of heating entire house to comfort. If not, what are

alternative modes of heating? ___________________________________

_____ Air Conditioning system is operable and in good working order.

_____ Hot water source is large enough for household needs and area around it is clean.

_____ Fireplaces, wood stoves and open faced heaters shall be made inaccessible to

children by the use of screens or other barriers.

_____ Hot water is between 105 and 120 degrees at the faucets.

_____ Smoke detectors are working, properly placed, and batteries are checked regularly

(every 3 months). A working smoke detector must be present in each bedroom.

_____ Hallways and bedrooms have clear passages, and all rooms including hallways,

passages, and outside doorways and walkways have adequate lighting.

Foster Home Safety Checklist Template