Religious Facility Safety Inspection Checklist Form
Use this Religious Facility Safety Inspection Checklist Form to document safety and maintenance conditions of a religious facility.
Facility Name and Location
*
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
First Name
Last Name
Facility Area or Zone Inspected
*
Occupancy / Use Status
*
Please Select
In Use
Vacant
Partially Occupied
Under Renovation
Other
Fire Safety Items (Select all that apply)
*
Fire extinguishers present and accessible
Smoke detectors functional
Sprinkler systems operational
Fire alarms tested
No fire hazards observed
Other
Emergency Exits / Egress (Select all that apply)
*
Exits clearly marked
Exit routes unobstructed
Exit doors functional
Emergency lighting operational
No egress issues observed
Other
Electrical Safety (Select all that apply)
*
No exposed wiring
Outlets and switches secure
Electrical panels accessible
No overloaded circuits
No electrical hazards observed
Other
Structural / Physical Hazards (Select all that apply)
*
Floors/walkways safe and clear
No leaks or water damage
No loose ceiling tiles or fixtures
Handrails secure
No trip hazards observed
Other
Accessibility / Safety Concerns (Select all that apply)
*
Entrances accessible
Restrooms accessible
Adequate lighting throughout
No blocked access routes
No accessibility issues observed
Other
Overall Findings and Follow-Up Actions / Recommendations
*
Submit Inspection
Should be Empty: