Senior Housing Inspection Checklist Form
Use this form to record a senior housing inspection, document checklist findings, note issues, and capture follow-up actions for the inspected property or unit.
Property and Inspection Details
Property or Facility Name
*
Property Address
*
Unit, Building, or Area Inspected
*
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
Inspection Type
*
Routine
Follow-up
Complaint
Move-in Readiness
Other
Inspection Checklist and Findings
Inspection Checklist Results
*
Rows
Pass
Needs Attention
Not Applicable
Exterior / Accessibility
1
2
3
Entryways
4
5
6
Hallways
7
8
9
Lighting
10
11
12
Flooring / Trip Hazards
13
14
15
Handrails
16
17
18
Bathrooms
19
20
21
Kitchen / Common Areas
22
23
24
Smoke / CO Detectors
25
26
27
Emergency Exits
28
29
30
Cleanliness
31
32
33
Pest Signs
34
35
36
HVAC / Heating / Cooling
37
38
39
General Safety
40
41
42
Overall Condition Rating
*
1
2
3
4
5
Inspection Findings Summary
Issues, Actions, and Follow-up
Issues Observed and Notes
*
Corrective Actions or Recommendations
*
Follow-Up Inspection Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Responsible Person
Submit Inspection
Should be Empty: