Playground Safety Inspection Report
Complete this form to document a comprehensive safety inspection of a playground.
Inspector Full Name
*
First Name
Last Name
Inspector Email Address
*
example@example.com
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Playground Name or Location
*
Weather Conditions During Inspection
*
Sunny
Cloudy
Rainy
Windy
Snowy
General Condition of Playground Equipment
*
Rows
Good
Needs Repair
Not Applicable
Slides
1
2
3
Swings
4
5
6
Climbing Structures
7
8
9
Seesaws
10
11
12
Benches
13
14
15
Fencing/Gates
16
17
18
Are there any visible hazards present?
*
No hazards observed
Yes, minor hazards
Yes, major hazards
List and describe any hazards found
Is the surfacing material in good condition?
*
Yes
No
Not Applicable
Recommendations or Actions Required
Overall Playground Safety Rating
*
1
2
3
4
5
Inspector's Signature
*
Submit Report
Submit Report
Should be Empty: