Residence Hall Inspection Form
Complete this form to document the condition and safety of residence hall rooms and common areas during inspection.
Inspector Full Name
*
First Name
Last Name
Inspection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Building Name or Residence Hall
*
Room Number or Area Inspected
*
Room Condition Assessment
*
Rows
Cleanliness
Furniture Condition
Walls/Ceiling Condition
Flooring Condition
Windows/Doors Condition
Excellent
1
2
3
4
5
Good
6
7
8
9
10
Fair
11
12
13
14
15
Poor
16
17
18
19
20
Are there any maintenance issues in the room?
*
No issues found
Yes, minor issues
Yes, major issues
Other (please specify)
Common Area Assessment
*
Rows
Hallways
Bathrooms
Laundry Room
Kitchen/Common Room
Clean
21
22
23
24
Satisfactory
25
26
27
28
Needs Attention
29
30
31
32
Not Applicable
33
34
35
36
Safety Equipment Check (select all that apply)
*
Smoke detector present and functional
Fire extinguisher present and accessible
Emergency exit clear
No safety hazards observed
Other (please specify)
Pest Control Observation
*
No signs of pests
Signs of pests observed
Not inspected
Additional Comments or Notes
Inspector Signature
*
Submit Inspection
Submit Inspection
Should be Empty: