For each home care setting inspect hazards and check the environment for hazards to your own and others’ health and safety and implement controls to manage risks for two different clients.
HAZARD INSPECTION FORM for two different clients
Part A. Student Information
Inspection conducted by:
Date completed:
Part B. Checklist
Secure the necessary permissions before conducting a hazard check in your client’s home.
For each of the items listed below, rate safety according to the following risk matrix:
Likelihood of an accident occurring as a result of this hazard
Potential Consequence
Negligible
Minor
Moderate
Major
Extreme
Almost Certain
Medium
High
High
Very High
Very High
Likely
Medium
Medium
High
High
Very High
Possible
Low
Medium
Medium
High
High
Unlikely
Low
Medium
Medium
Medium
High
Rare
Low
Low
Low
Medium
Medium
Where you answer Medium, High or Very High, add comments how the hazard was addressed, i.e. reported to supervisor, isolated hazard, or indicate specific actions taken.
Area
Risk Rating
Comments
Grounds
Adequate exterior lighting provided and maintained.
Choose an item.
Pathways
Free from jagged or protruding surfaces/objects (including significant cracks).
Wide enough for intended use (including wheelchair access).
Choose an item.
Steps / Stairs / Ramps
Handrails provided when there are more than two risers.
Treads provided and maintained in good condition.
Slope of ramp appropriate for wheelchair access.
Choose an item.
Ground surfaces
Free from jagged or protruding surfaces/objects.
Choose an item.
Roof areas
Access limited.
Maintained in good order.
Guttering securely attached, no build-up of leaves, etc.
Choose an item.
Pool area
Securely fenced to restrict non-supervised access.
Chemicals correctly stored.
Choose an item.
Clothes line
Stable.
Wires secured and taut.
Height adjustable.
Suitable access pathway.
Choose an item.
Bathroom (all bathrooms in the house)
Non-slip flooring.
Change bench provided (where necessary).
Bathing aids provided where appropriate.
Waste Water drain in floor.
Adequate storage for linen and toiletries.
Hoist provided (where necessary)
Appliances (for example hair drier) kept away from water.
Appliances kept out of reach of children.
Exhaust fans functioning.
Choose an item.
Toilet (all toilets in the house)
Condition of floors, walls and ceiling.
Condition of fittings and fixtures.
Choose an item.
Lounge room
Sufficient space for storage and movement.
Lounge chairs suitable for needs of client AND caregiver.
Television and Video (no piggyback plugs).
Choose an item.
Laundry
Detergents/soaps and other chemicals stored securely.
Protective equipment and clothing available for chemical use.
All chemicals stored in original container.
Non-slip flooring.
Washing machine / drier securely fixed in position.
Adequate bench space for clothes sorting.
Trolley available for moving clothes basket.
Waste Water drain in floor.
Adequate ventilation to prevent build-up of condensation.
Choose an item.
Kitchen / Dining room
Stove / oven / microwave securely fixed in position.
Sharp objects (including knives) kept in secure storage.
Non slip floor surface.
Detergents/cleaners/poisons stored away from foodstuffs.
Protective equipment provided for chemical use.
Cyclical removal and cleaning of filters in extraction hoods.
First aid supplies accessible.
Fire Blanket appropriately located.
Location of nearest extinguisher clearly signposted.
Electronically lit gas burners.
Bench height appropriate to needs of users.
All chemicals stored in original containers.
All plastic bags securely stored.
Pet feeding utensils kept separate from those used for humans.
Good hygiene standards maintained.
Adequate storage provided.
Free from infestation of rodents or insects.
Waste containers supplied with lids and emptied regularly.
Chairs and tables in good order.
Choose an item.
Bedroom (all bedrooms in the house)
Sufficient space for storage and movement.
Bed height suitable for working needs of care giver.
Condition of doors and windows.
Choose an item.
Electrical systems
Wiring maintained in good condition.
Cords on all appliances safe to use.
Power sockets / plugs secure and safe for use.
Appliances safety stored.
Appliances kept away from water.
No overloading of power points.
Electrical Safety Switch installed.
Hard wired smoke detectors installed.
Choose an item.
Windows / Doors
Sufficient doorway width for wheelchair access.
Full height glazed doors clearly marked at eye level.
Fly wire screens intact.
No sticking doors or windows.
Choose an item.
Heating / Cooling systems
Guards provided around heaters where necessary.
No portable bar radiators in use.
Heaters used and maintained in line with manufacturer’s instructions.