Foster Home Inspection Checklist Template - Washington Department Of Social & Health Services
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3CHILDREN’S ADMINISTRATION
DIVISION OF LICENSED RESOURCES
Foster Home Inspection Checklist
APPLICANT / PROVIDER NAME
TELEPHONE NUMBER
INSPECTION DATE
ADDRESS
CITY
STATE
ZIP CODE
WA
Place appropriate CODE in the space provided.
C = Rule is met
X = Rule is not met
D = Discussed with foster parent
W = Exception granted
N/A = Not applicable
Health and Safety
Comments / Notes / Corrections
1440
Facility is clean, sanitary, and free of hazards including window
blind cords.
Home has adequate ventilation.
Light fixtures provide children good visibility and comfort.
Room temperatures at reasonable levels.
Premises are free from pests.
Toxic materials are out of reach of children and separated from
food items
Home has adequate laundry and drying facilities or makes other
arrangements on a regular basis.
Easy access to the outside in case of an emergency.
All doors open easily from the inside and outside.
Supervision plan is in place if hazardous conditions exist.
1445
Sewage is discharged into a public or functioning system or into
a DOH and/or tribal approved alternate system.
Water is from public system or approved private supply.
Water temperature does not exceed 120 degrees.
1450
Disinfect diaper-changing areas and toilet-training equipment
between each use of use disposable covering.
Electrical outlets are tamper-proof if needed.
Access to working telephone at all times when children are
present in the home.
Address is clearly visible and location is accessible.
Poison control number is posted on or near telephone.
Wheeled baby walkers will not be used.
1455
Pools or other bodies of water are fenced with locking gate or
other DLR approved safety device.
Hot tubs locked when not in use.
A supervision plan is in place when the home has a pool or
bodies of water.
1460
Family conducts at least quarterly fire drills with children.
Family has emergency supplies of food, water, medication, and
other necessary supplies.
Family has a written evacuation plan for the home.
1480
Pets and animals are safe and cared for in a sanitary manner.
Complies with local, state, or federal regulations regarding:
animal safety, vaccinations, and standard veterinary care.
1485
Alcoholic beverages and marijuana are inaccessible.
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DSHS 10-183 (REV. 01/2015)
DISTRIBUTION: File Applicant
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