Sample Student Room Inspection Form printable pdf download

Sample Student Room Inspection Form

SAMPLE INSPECTION FORM

STUDENT ROOM

1. ROOM NUMBER *

2. CLEANLINESS, HEALTH AND HYGIENE *

Reasonable efforts must be made to maintain proper personal cleanliness and hygiene. Rooms

and apartments must be kept clean and sanitary at all times.

Check all that apply.

¨ none

¨ dirty ceiling

¨ dirty floor

¨ dirty mirror

¨ dirty vanity/sink

¨ dirty wall(s)

¨ excessive trash

¨ empty alcohol containers

¨ Other:

3. FIRE ALARM/FIRE SAFETY *

Check all that apply.

¨ none

¨ removed, covered, or disabled smoke detector covered or items attached to sprinkler

disabled or removed door closer

¨ prohibited cooking device

Other:

4. ELECRICAL SAFETY *

Check all that apply.

¨ none

¨ extension cords

¨ more than two power strips

¨ power strips plugged into each other modifications to wiring

¨ octopus or multi-outlet device

¨ no breaker on power strip

¨ Other:

5. OTHER POLICIES *

Check all that apply.

¨ None

¨ Appliances

¨ Bicycles Candles/Incense/Flamables Damages/Vandalism Decorating/Posting

Doors/Door Locks

¨ Drugs

¨ Explosives

¨ Halogen Lamps

¨ Pets

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Sample Student Room Inspection Form