Daily Station Inspection Form Home Daily Report Form Station Inspection Form Station Procedures Daily Station Inspection Form 1. General InformationInspection Date MM slash DD slash YYYY Time(Required) Hours : Minutes AM PM AM/PM Location:Inspected by:Weather Conditions:(Required)Sunny/HotClear/CoolOvercastRain2. Playground SurfaceSurface(Required) Yes No Surface level is even and free of hazardsAdequate impact-absorbing material present (e.g. mulch, rubber)(Required) Yes No No standing water or erosion areas(Required) Yes No Comments:3. Equipment ConditionNo broken or damaged Parts(Required) Yes No All bolts and screws are secure(Required) Yes No No sharp edges or protruding parts(Required) Yes No Moving parts function correctly/smoothly(Required) Yes No Comments:4. Safety FeaturesAdequate fall zones around equipment(Required) Yes No Guardrails and barriers are secure(Required) Yes No Equipment height appropriate for age group(Required) Yes No Signage present and legible (rules, age range, etc.)(Required) Yes No Comments:5. Surrounding AreaArea is free of trash and debris(Required) Yes No No obstructive vegetation or hazards(Required) Yes No Fence or boundary secure (if applicable)(Required) Yes No Comments:6. Corrective Actions NeededIssue:Action Taken/RecommendedResponsible PartyCompletion Date MM slash DD slash YYYY 7. Inspector's SignoffNameDate MM slash DD slash YYYY Δ
