Child Foster Care Home Safety Checklist - Department Of Human Services
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1
2Department of Human Services
Licensing Division - Family Systems
Child Foster Care
Home Safety Checklist
Child Foster Care (CFC) – Prior to licensure the foster home must be inspected by a licensing agency employee using
the home safety checklist from the Commissioner of human services.*
Name of License Holder/Program: ____________________________________________________________
Emergency Procedures
The following items must be posted and/or readily accessible in a prominent location in a common area of
the home where they can be easily observed by a person responding to an incident.
Yes
No 1. A list of emergency phone numbers.
Yes
No 2. A written fire/emergency escape plan
Yes
No 3. An operable flashlight and radio or television set that does not require electricity.
Yes
No 4. Accessible first-aid supplies.
Yes
No 5. An operable telephone.
_____________________________________________________________________________
Physical Environment
Yes
No 1. Exit doors and windows are not obstructed and are easily opened from the inside.
Yes
No 2. The wiring appears safe; no known hazards exist.
Yes
No 3. Extension cords are appropriately used and are not used in place of permanent wiring.
Yes
No 4. A fire extinguisher with a minimum rating of 2A:10BC is maintained in the home.
Yes
No 5. All smoke detectors work and are properly installed on all levels of the home.
Yes
No 6. All interior doors can be unlocked from the outside and the opening device is readily
accessible in case of emergency.
Yes
No 7. Home is clean and free from accumulations of dirt, grease, garbage, peeling paint, vermin
and insects.
Yes
No 8. Outside property is free from debris and safety hazards. Exterior stairs and walkways
are free of ice and snow.
Yes
No 9. Fireplaces, wood burning stoves, and hot surfaces are protected by guards in order to
prevent burns.
Yes
No 10. Furnaces are maintained in good working condition.
________________________________________________________________________________________
Home Safety & Health
Yes
No 1. Knives, tools, matches, and other potentially hazardous materials are not accessible to
children as identified in the out-of-home placement plan, or other service plan.
Yes
No 2. Chemicals, detergents, and other toxic substances are not stored with food products or in
any way that poses a risk to children.
Yes
No 3. Combustible items are properly stored at least 36” from any heating sources.
Yes
No 4. Individual clean bed linens, towels, and wash cloths are provided for each foster child.
Yes
No 5. Food is handled and properly stored to prevent contamination, spoilage, or a threat to
the health of children.
August 2017
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