Appendix E: Sample Playground Inspection Form

Kelly McKown

Sample Playground Inspection Form[1]

Playground Location: ______________________

 

Inspected By: ____________________________

Time: ________________

 

Date:  ________________

 

 

General Hazards OK IF NOT OK, COMMENTS OR ACTIONS TO BE TAKEN
1.       There are no sharp points, corners, or edges? ­­­­­­­­­­­

 

2.       There are no protrusions or projections?  

 

3.       There are no pinch points, crush points, or exposed moving parts?
4.       Potential clothing entanglement hazards have been eliminated?  

 

5.       There are no missing or damaged protective caps or plugs?
6.       Hanging tree branches have been trimmed (6’ clearance)?
7.       Fall zones not per CPSC (6’ perimeter all directions)?  

 

8.       Openings < 3 ½” or > 9” to prevent head entrapment? ­­­­­­­­­

 

9.       Footings exposed, cracked or loose in ground?  

 

10.    Trip hazards, broken glass, trash, ropes, tree roots or foreign objects in play area have been removed? ­
Play Structures OK IF NOT OK, COMMENTS OR ACTIONS TO BE TAKEN
1.       Broken supports or anchors?
2.       Pipe ends missing plugs or caps?
3.       Broken or missing rails/rungs/steps? ­­
4.       Protruding bolt heads or threads?
5.       Loose, missing, worn or rusted bolts/nuts/or other fasteners?
6.       Broken clamps?
7.       Peeling or chipped paint? ­
8.       Entrapment/pinch or crush points?
9.       Vinyl coated decks/platforms/steps have visible cracks or peeling?
10.    Excessive wear of any component/slide part?
11.    Wooden equipment is free of splinters, checking, large cracks, warping, and rot?
12.    General condition/appearance? _____ Good    _____ Fair   _____ Poor

 

Slides OK IF NOT OK, COMMENTS OR ACTIONS TO BE TAKEN

 

1.       Slide bedways have imperfections?
2.       Handrails loose or missing?
3.       Steps broken or missing, or flaws/cracks?
4.       Sit down transition platform present?
5.       Safety rails or sit-down canopy at bedway entry present?
6.       Slide exit parallel to ground?
7.       Safety surface at slide exit has been leveled or repaired?
8.       Fall zone adequate on all sides?
9.       General condition/appearance? _____ Good   _____ Fair   _____ Poor

 

Swings OK IF NOT OK, COMMENTS OR ACTIONS TO BE TAKEN
1.       Broken, twisted, worn, rusted chain?
2.       Inadequate (non-commercial) chain? ­­­­­­­­­­­­­­­­­­­­­­
3.       Worn, rusted or broken swing hangers?
4.       Open, worn or rusted “S” hooks (dime will not pass through)?
5.       Grommets show wear or rust?
6.       Missing, worn or cracked swing seats?
7.       Inadequate fall zone around swings?
8.       Swing frame damaged?
9.       Swing chain wrapped around top rail?
10.    Safety surface worn or scattered?
11.    Loose, missing or protruding bolts?
12.    General condition/appearance?  

_____ Good   _____ Fair   _____ Poor

 

Surfacing OK IF NOT OK, COMMENTS OR ACTIONS TO BE TAKEN
1.       Safety surface depth sufficient (12”)?  

 

2.       Inadequate safety surface material (other than ASTM surfacing material)?
3.       Does safety surface comply with ADA? _____ Yes   _____ No   _____ Don’t know
4.       Poor drainage area (standing water) or potential problems?  

 

5.       Areas of compaction, kick-out, or wear have been leveled or repaired? ­­­­­­­­­­­­­­­­­­­­­­­
6.       Sidewalks, paved surfaces, steps, and platforms have been swept or cleaned of loose surface materials and debris?

 

Freestanding Climbers/Monkey Bars OK IF NOT OK, COMMENTS OR ACTIONS TO BE TAKEN
1.       Not free-fall design?
2.       Loose or broken rails or rungs?
3.       Need painting?
4.       Tire worn, cut or broken?
5.       Plastic structures are free of holes and cracks?
6.       General condition/appearance? _____ Good   _____ Fair   _____ Poor

 

NOTES/COMMENTS: 

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Appendix E: Sample Playground Inspection Form Copyright © by Kelly McKown is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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