EmailMeForm
Site Safety Inspection
Site Safety Inspection, Please check all rooms, cupboards, drawers and wardrobes.
Location
*
Date Time
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Client Name
*
First
Last
Support Worker
*
First
Last
Notes
Exits and rapid leave plan are understood
Yes
No
Secure lockable rooms identified e.g. bathroom for safety
Yes
No
Concerns over room location - Absconding risk identified
Yes
No
External doors from bedroom
Fences and gates
Potential escape routes
Concerns over room location - Please explain e.g. 2nd storey
Yes
No
High traffic area/busy road
Other people at the location
Location of property e.g. near a river/stream
Swimming pool
Balcony
At risk items removed and put away e.g. taken to the car boot or locked away securely.
Yes checked/removed
Risk minimised as much as possible
Not an identified risk
Knives and other dangerous cutlery
Grater
Peeler
Pencil sharpner
Razors
Scissors
Coat hangers (if metal)
Photo frames/unsecured mirrors/glass items
Ovens/heaters
Door handles/ ligature points
Movie DVD's/CD's
Flexes/dressing gown cords
At risk items removed and put away e.g. taken to the car boot or locked away securely. Chemicals
Yes checked/removed
Risk minimised as much as possible
Not an identified risk
Dishwash
Mouthwash
Medicated creams
Laundray powder
Cleaning chemicals
Fly spray
Spray deodorant or other aerosols
At risk items removed and put away e.g. taken to the car boot or locked away securely.
Yes checked/removed
Risk minimised as much as possible
Not an identified risk
Medications
Vacuum cleaners - returned to reception due to cords
Iron - Returned to reception due to cords
Any unnecessar electrical items with cords (excluding kettle and TV)
Lighters or matches
Items containing betteries, clocks, remotes
Phone/tap;et/laptop chargers
Own cellphone/car keys
Drinks cans (tins)
At risk items removed and put away e.g. taken to the car boot or locked away securely.
Yes checked/removed
Risk minimised as much as possible
Not an identified risk
No overload electrical outlets or frayed/open wires
Concerns Notes
Any other health and safety risks or concerns noted
I confirm that
Yes
No
I am aware of the exits, and they are clearly marked
I am aware of the fire and evacuation procedure and assembly point
I have access to an appropriately stocked first aid kit
There is disable access (if required)
I am aware of site-specific hazards
Smoke alarm(s) are working
Any ligature concerns have been escalated to the person's referrer
Signature
Clear
Name
*
First
Last
Date Time
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MM
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