Smoke Detector Safety Checklist Form
Complete this checklist to record the safety status of smoke detectors in the property.
Property/Location Name or Unit Identifier
*
Inspector Name
*
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Smoke Detector Locations Checked
*
Living Room
Kitchen
Bedroom 1
Bedroom 2
Hallway
Basement
Garage
Other
Detector Status by Location
*
Rows
Working
Needs Battery Replacement
Needs Replacement
Not Present
Unknown
Living Room
1
2
3
4
5
Kitchen
6
7
8
9
10
Bedroom 1
11
12
13
14
15
Bedroom 2
16
17
18
19
20
Hallway
21
22
23
24
25
Basement
26
27
28
29
30
Garage
31
32
33
34
35
Other
36
37
38
39
40
Battery Condition or Power Source Status
*
Battery good
Battery low
Battery missing
Hardwired (no battery)
Unknown
Test Result After Pressing Test Button
*
Alarm sounded
No sound
Weak sound
Not tested
Was any obstruction, dust, or damage observed?
*
No issues observed
Obstructed
Dusty/Dirty
Damaged
Required Follow-Up Actions (Select all that apply)
Replace battery
Replace detector
Install detector
Clean unit
Re-test
Contact maintenance
No action needed
Other
Additional Notes or Comments
Submit Checklist
Should be Empty: