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Sample Playground Inspection Form[1] (18/11) -- ECE 142: Health, Safety and Nutrition. S...

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Sample Playground Inspection Form[1]

Sample Playground Inspection Form[1] | Playground Location: | Time: | | Inspected By: | Date: | | General Hazards | OK | Not Okay… Comments or Actions to be Taken | | 1. There are no sharp points, corners, or edges? | | | | 2. There are no protrusions or projections? | || | 3. There are no pinch points, crush points, or exposed moving parts? | || | 4. Potential clothing entanglement hazards have been eliminated? | || | 5. There are no missing or damaged protective caps or plugs? | || | 6. Hanging tree branches have been trimmed (6’ clearance)? | || | 7. Fall zones not per CPSC (6’ perimeter all directions)? | || | 8. Openings < 3 ½” or > 9” to prevent head entrapment? | | | | 9. Footings exposed, cracked or loose in ground? | || | 10. Trip hazards, broken glass, trash, ropes, tree roots or foreign objects in play area have been removed? | | Play Structures | OK | Not Okay … Comments or Actions to be Taken | | 1. Broken supports or anchors? | || | 2. Pipe ends missing plugs or caps? | || | 3. Broken or missing rails/rungs/steps? | | | | 4. Protruding bolt heads or threads? | || | 5. Loose, missing, worn or rusted bolts/nuts/or other fasteners? | || | 6. Broken clamps? | || | 7. Peeling or chipped paint? | | | | 8. Entrapment/pinch or crush points? | || | 9. Vinyl coated decks/platforms/steps have visible cracks or peeling? | || | 10. Excessive wear of any component/slide part? | || | 11. Wooden equipment is free of splinters, checking, large cracks, warping, and rot? | || | 12. General condition/appearance? | Good, Fair, or Poor | | Slides | OK | Not Okay … Comments or Actions to be Taken | | 1. Slide bedways have imperfections? | || | 2. Handrails loose or missing? | || | 3. Steps broken or missing, or flaws/cracks? | || | 4. Sit down transition platform present? | || | 5. Safety rails or sit-down canopy at bedway entry present? | || | 6. Slide exit parallel to ground? | || | 7. Safety surface at slide exit has been leveled or repaired? | || | 8. Fall zone adequate on all sides? | || | 9. General condition/appearance? | Good, Fair, or Poor | | Swings | OK | Not Okay … Comments or Actions to be Taken | | 1. Broken, twisted, worn, rusted chain? | || | 2. Inadequate (non-commercial) chain? | | | | 3. Worn, rusted or broken swing hangers? | || | 4. Open, worn or rusted “S” hooks (dime will not pass through)? | || | 5. Grommets show wear or rust? | || | 6. Missing, worn or cracked swing seats? | || | 7. Inadequate fall zone around swings? | || | 8. Swing frame damaged? | || | 9. Swing chain wrapped around top rail? | || | 10. Safety surface worn or scattered? | || | 11. Loose, missing or protruding bolts? | || | 12. General condition/appearance? | Good, Fair, or Poor | | Surfacing | OK | Not Okay … Comments or Actions to be Taken | | 1. Safety surface depth sufficient (12”)? | || | 2. Inadequate safety surface material (other than ASTM surfacing material)? | || | 3. Does safety surface comply with ADA? | || | 4. Poor drainage area (standing water) or
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