Prehospital Home Safety Checklist
This survey is provided as an educational service and is not intended to be exhaustive or certify a residence as safe or unsafe. We advice occupants to seek additional information if questions arise.
| OK | Needs Improvement | |
| Bathroom | ||
| Non-skid mats or decals in tub |
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| Stairs (inside and outdoors) | ||
| Well-lit | |
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| Sturdy handrail along length of stairs |
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| Bedroom | ||
| Phone next to bed (may be by report) |
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| General | ||
| Secure carpeting on floors and staircases |
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| Fire Safety | ||
| Smoke detector functional | |
|
| Fire extinguisher (in kitchen or nearby) |
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| Child Safety (if applicable) | ||
| Plastic plugs in unused electrical outlets | |
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| Cleaners out-of-reach or in locked cabinets | |
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| Medicines out-of-reach or in locked cabinets | |
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| Child safety-gates installed around hazards | |
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Online March 28, 2002