Egress Door Inspection Checklist Form
Use this form to record routine egress door inspection results, note deficiencies, and track corrective actions.
Inspection Details
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspection Time
*
Hour Minutes
AM
PM
AM/PM Option
Inspector Name
*
Inspector Role or Department
Please Select
Facilities
Maintenance
Safety
Security
Operations
Other
Site/Building Name
*
Exact Location of Egress Door
*
Egress Door Identification
Egress Door ID or Label
*
Door Type
*
Swinging Door
Double Door
Fire Exit Door
Other
Floor or Area Served
*
Physical Condition Checklist
Door frame condition
*
Pass
Fail
Not Applicable
Door leaf/panel condition
*
Pass
Fail
Not Applicable
Hinges condition
*
Pass
Fail
Not Applicable
Door closer condition
*
Pass
Fail
Not Applicable
Latch/lock condition
*
Pass
Fail
Not Applicable
Panic hardware condition (if applicable)
Pass
Fail
Not Applicable
Signage condition
*
Pass
Fail
Not Applicable
Visibility and lighting around the door
*
Pass
Fail
Not Applicable
Clearance and Accessibility Checks
Door area free of obstructions
*
Pass
Fail
N/A
Egress path clear
*
Pass
Fail
N/A
Door opens fully without interference
*
Pass
Fail
N/A
Door swing unobstructed
*
Pass
Fail
N/A
Notes for exceptions or blocked access
Operational Test Results
Opens from egress side without a key or special knowledge
*
Yes
No
Closes and latches properly
*
Pass
Fail
Self-closing function works properly
*
Pass
Fail
Alarms or hold-open devices operate correctly if installed
Pass
Fail
Not Installed
Overall test result
*
Pass
Fail
Deficiencies and Corrective Actions
Deficiencies Summary
*
Severity Level
*
Minor
Moderate
Major
Critical
Corrective Action Required
*
Responsible Person or Team
Target Completion Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Immediate Action Required
*
Yes
No
Final Verification
Inspector Comments or Recommendations
Reinspection Required?
*
Yes
No
Verification Status
*
Please Select
Completed
Pending
Failed
Needs Recheck
Inspector Acknowledgment
Submit Inspection
Submit Inspection
Should be Empty: