Fillable Site Safety Checklist Form printable pdf download

Site Safety Checklist Form

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Site Safety Checklist

This form is required for meetings in non-public

buildings and is recommended as a planning tool

for identifying locations for events. This form is

due to the Service Unit Manager prior to meeting

in a non-public building.

Troop Leader/Event Organizer:

Phone:

E-mail:

Name of Site:

Site Address:

Is this site in a public building such as a:

public or private school

place of worship

Other (specify)

Is the site in a non-public building such as a:

private home

private business building

SITE INFORMATION

Check “Yes” or “No” for the following:

YES

Are first-aid supplies and/or emergency facilities available?

Are clean and sanitary toilets and hand-washing facilities available? Are they well-stocked with toilet paper

and soap?

Are telephones or other means of communication available? If using a mobile phone, does the area have

good reception?

Is adequate lighting available both inside the building and on the exterior grounds? Are pathways clearly lit?

Is there at least one emergency exit in addition to the main entrance?

Are the exits functioning, easily accessible, well-marked, and adequately lit?

Are the main entrance and emergency exit(s), and the route to access these exits, free of any blocks and

barriers?

Is access to clean drinking water available?

Is a working fire extinguisher available?

Are there working fire alarms, smoke detectors, and carbon monoxide detectors?

Are all medications, chemicals, sharp objects, weapons, and other potentially dangerous items securely

stored in a location that can not be accessed by children? Are these items when securely stored also out of

children's reach and eyesight?

Are the building and grounds safe and secure and able to control access from unwanted visitors?

Is the site well-ventilated and well-heated?

Are the building and grounds free of any hazards such as broken windows, walkways covered in ice, etc.?

If there are pools and/or hot tubs on the site, is access to them locked when they are not being used?

Are the building and grounds clean, sanitary, and free from debris?

Is the site large enough to safely accommodate all participants and effectively hold a meeting and/or event?

Site Safety Checklist Form

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